Measuring scales used for assessment of patients with traumatic brain injury: multicenter studies

Abstract

BackgroundApplication of adequate numeric scales is essential for assessment of a patient’s condition. The scales most commonly used by the therapeutic team for assessment of a patient with traumatic brain injury (TBI) include deficit scales, functional scales, and scales assessing quality of life. The purpose of this study was to establish the relationships between the particular scales used for assessment of patients with TBI.MethodsThis multicenter study included 159 patients with TBI. The direct observation technique was used. Two measurements were made (at hospital admission and discharge) using standardized assessment scales, ie, the Glasgow Coma Scale (GCS), the Functional Capacity Scale (FCS), the Functional Index “Repty” (FIR), and the Glasgow Outcome Scale.ResultsPatients with mild impairment of consciousness were most numerous in the examined group at both admission and discharge, ie, 118 (78.8%) and 134 patients (89.3%), respectively. The mean score for functional capacity measured with the FCS was 34.41 points (71.7%) on the day of admission and 41.87 points (87.2%) on the day of discharge from hospital. A significant correlation was found between results obtained using the GCS and results on the FIR, on both the day of admission [R t(n-2) =7.612=0.530; P=0.00] and the day of discharge [R t(n-2) =8.998=0.595; P=0.00]. Further, a high correlation was found between the FCS and the FIR (rs= −0.854 on day of admission and rs= −0.840 on day of discharge).ConclusionThe majority of examined patients had mild impairment of consciousness. A moderate correlation was found between the GCS and the scales assessing activities of daily living. A high correlation was found between FCS and FIR, which may result from the similarities between the analyzed tools in the scope of their construction and application.

Scales for assessment of patients with traumatic brain injury

“…Although some studies have described the recovery of patients of TBI after trauma, there are few studies that evaluate the different aspects of functional capacity in the acute phase after brain injury and factors related to outcome. We agree with Ślusarz et al 1 that studying the functional capacity and assessing the activities of daily living in patients with TBI facilitate the planning of systematic assistance, implementation of neurological rehabilitation, reintegration of patients in society, and a better warranted quality of life. A strength of the study is to analyze the functional capacity assessed by different scales at admission and at discharge, highlighting the correlation of recovery in both periods with the level of awareness, and the comparison of different scales that assess functional capacity and activities of daily life.…”

“…We read with great interest the paper by Ślusarz et al 1 published in the Patient Preference and Adherence . The functional recovery after traumatic brain injury (TBI) is related to the severity of the brain lesion and the time after TBI.…”

“…As a result, the pathophysiology of disability after TBI and the mechanisms involved in functional recovery are the subject of investigations, which provide the foundation to direct rehabilitation programs and guide the development of individualized therapy after TBI. 3 Ślusarz et al’s 1 article focused on the role of establishing the relationships between measurements by the Glasgow Coma Scale (GCS) and the scales used for the assessment of functional capacity of TBI patients.…”

“…Our group has great interest in the assessment of functional recovery of TBI patients analyzed by different scales, in particular, patients with severe diffuse axonal injury (DAI). 3 , 4 As discussed by Ślusarz et al, 1 the evaluation of consciousness is a widely used prognostic parameter in the acute phase of trauma and identifies early the outcome of patients with severe TBI, and it is relevant in the face of the impairment of brain functions caused after TBI and the mechanisms involved in the recovery process. Clinical observations of TBI patients have suggested improvement during the first year, particularly during the first 6 months, with stabilizing of the recovery process thereafter.…”

Activation of Sphingosine 1-Phosphate Receptor 1 Enhances Hippocampus Neurogenesis in a Rat Model of Traumatic Brain Injury: An Involvement of MEK/Erk Signaling Pathway

“…Traumatic brain injury (TBI) is a commonly-seen cause of brain damage and often results in a series of nonreversible neuronal loss and neurological deficits [1, 2]. Neural stem cells (NSCs), located in the subgranular zone (SGZ) of hippocampal dentate gyrus (DG), are capable of proliferating, differentiating, and integrating into the existing neuronal circuits that play a pivotal role in neurogenesis throughout life in mammalian brain [3, 4].…”