| Summary: | 碩士 === 中山醫學大學 === 護理研究所 === 98 === Traumatic brain injury related morbidity and mortality gradually exceed other diseases in recent years. Among the morbidities, cognitive impairment can lead to a longer disable period than physical impairment. In this study, we investigated whether cognitive function evaluation in the acute phase was predictive of functional outcome. This is a prospective and descriptive study which enrolled 77 traumatic brain injury patients, including 52 mild and 25 moderate-severe injuries, by purposeful sampling in a regional teaching hospital from 15 August 2009 to 15 February 2010. Structural evaluation, including Glasgow Coma Scale (GCS), Rancho Los Amigos levels of cognitive function Scale (RLAS), Galveston Orientation and Amnesia Test (GOAT), of each patient will be recorded by interviews and observations on the day of admission and the day of discharge. Glasgow Outcome Scale - Extended (GOSE) was used to evaluate the functional outcome 3 months after the injury. After gathering the data, statistical analysis was processed by SPSS 17.0 software for mild and moderate-severe traumatic brain injury patients. Descriptive statistical analysis includes frequency-distribution, percentage, mean, and standard deviation; inferential statistics analysis includes paired-samples t test, simple regression, and multiple regression.
The result of this study indicated that age was related to the outcome. After adjusting for the factor of age, the addition of GOAT or RLAS on the day of admission and the day of discharge increases predictive value of the 3 months functional outcome in patients with mild traumatic brain injury. However, only GCS on the day of discharge was predictive, in the group of moderate-severe traumatic brain injury patients. We recommend including RLAS and GOAT to the routine evaluation for patients of traumatic brain injury, which can offer additional information to medical groups and to know potential cognitive defects and possible preliminary outcome for the family and for discharge plans.
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