Predictive Value of a New Brief Cognitive Test for Long-term Functional Outcome in Acute Traumatic Brain Injury

Area of Science:

• Neuroscience
• Clinical Psychology
• Rehabilitation Medicine

Background:

• Traumatic brain injury (TBI) poses significant challenges for assessing cognitive function during the acute phase.
• Predicting long-term functional outcomes after TBI is crucial for patient management and rehabilitation planning.
• Posttraumatic amnesia (PTA) is a recognized predictor, but brief, early cognitive assessments may offer additional prognostic value.

Purpose of the Study:

• To evaluate the predictive accuracy of the EXAmen Cognitif abrégé en Traumatologie (EXACT) for long-term functional outcomes following moderate to severe TBI.
• To compare the predictive power of the EXACT with the length of posttraumatic amnesia (PTA).

Main Methods:

• An inception cohort of 90 patients hospitalized for moderate or severe TBI was studied.
• Performance on the EXACT was assessed within 3 months post-injury.
• Long-term functional outcomes were measured using the Disability Rating Scale (DRS) at 1-2 years follow-up.

Main Results:

• EXACT scores correlated with PTA duration and DRS outcomes.
• The EXACT significantly improved the prediction of functional outcomes compared to PTA alone.
• A total EXACT score ≤80 indicated a higher likelihood of long-term disability.
• Impairments were most pronounced in behavioral regulation and executive functions, followed by attention, working memory, and episodic memory.

Conclusions:

• The EXACT is a feasible and valuable tool for early cognitive assessment in acute TBI.
• EXACT results, combined with PTA, can aid in estimating long-term functional sequelae.
• The EXACT shows promise as a brief cognitive instrument for future TBI recovery research.