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Accuracy of self-reported length of coma and posttraumatic amnesia in persons with medically verified traumatic brain
Mark Sherer1, Angelle M Sander2, Kacey Little Maestas1
1TIRR Memorial Hermann, Houston, TX; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX.
Objective:
To determine the accuracy of self-reported length of coma and posttraumatic amnesia (PTA) in persons with medically verified traumatic brain injury (TBI) and to investigate factors that affect self-report of length of coma and PTA duration.
Design:
Prospective cohort study.
Setting:
Specialized rehabilitation center with inpatient and outpatient programs.
Participants:
Persons (N=242) with medically verified TBI who were identified from a registry of persons who had previously participated in TBI-related research.
Intervention:
Not applicable.
Main Outcome Measures:
Self-reported length of coma and self-reported PTA duration.
Results:
Review of medical records revealed that the mean medically documented length of coma and PTA duration was 6.9±12 and 19.2±22 days, respectively, and the mean self-reported length of coma and PTA duration was 16.7±22 and 106±194 days, respectively. The average discrepancy between self-report and medical record for length of coma and PTA duration was 8.2±21 and 64±176 days, respectively. Multivariable regression models revealed that time since injury, performance on cognitive tests, and medical record values were associated with self-reported values for both length of coma and PTA duration.
Conclusions:
In this investigation, persons with medically verified TBI showed poor accuracy in their self-report of length of coma and PTA duration. Discrepancies were large enough to affect injury severity classification. Caution should be exercised when considering self-report of length of coma and PTA duration.
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The severity and duration of memory loss vary depending on the type and underlying cause. Amnesia is classified into two main types: retrograde and anterograde.
Retrograde amnesia is marked by the loss of memories formed before the onset of the condition. Patients may recall distant past events but often forget those occurring shortly before the incident.
Anterograde...