Identifying posttraumatic amnesia in individuals with a Glasgow Coma Scale of 15 after mild traumatic brain injury

Susanne Meares, E. Arthur Shores, Tracy Smyth, Jennifer Batchelor, Margaret Murphy, Matthew Vukasovic

Research output: Contribution to journalArticleResearchpeer-review

Abstract

OBJECTIVE: To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale, which includes the Glasgow Coma Scale (GCS) and 3 picture cards used to measure amnesia, in identifying the presence or absence of posttraumatic amnesia in individuals with mild traumatic brain injury (mTBI).

DESIGN: Prospective study using data from the Abbreviated Westmead Post-traumatic Amnesia Scale.

SETTING: Trauma hospital.

PARTICIPANTS: Individuals with possible mTBI who presented between April and September 2011 (N=252; age range, 18-65y; mean age, 37.4±13.9y; 77% men).

INTERVENTION: Administration of the Abbreviated Westmead Post-traumatic Amnesia Scale.

MAIN OUTCOME MEASURES: GCS and Abbreviated Westmead Post-traumatic Amnesia Scale pass/fail rates.

RESULTS: Of the individuals, 169 (mean age, 35.1±13.6y; 77% men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89-205min) after triage. Of the 45 who failed, 31 (69%) had a GCS score of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.06; P<.05), having consumed alcohol (OR, 3.09; 95% CI, 1.42-6.74; P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95% CI, 0.99-1.00; P<.05). Nineteen (42%) of those who failed had consumed alcohol, 11 had a GCS score of 15, and 8 had a GCS score of 14.

CONCLUSIONS: A GCS score of 15 does not always signify return to normative cognitive function. Individuals with a GCS score of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the Abbreviated Westmead Post-traumatic Amnesia Scale will assist in making a diagnosis of mTBI.

LanguageEnglish
Article number56074
Pages956-959
Number of pages4
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number5
DOIs
Publication statusPublished - 1 May 2015

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Brain Concussion
Glasgow Coma Scale
Amnesia
Odds Ratio
Confidence Intervals
Alcohols
Triage
Wounds and Injuries
Cognition
Prospective Studies

Keywords

  • Amnesia
  • anterograde
  • Brain injuries
  • Rehabilitation

Cite this

@article{ae27061c04e84389b75735a6935e6044,
title = "Identifying posttraumatic amnesia in individuals with a Glasgow Coma Scale of 15 after mild traumatic brain injury",
abstract = "OBJECTIVE: To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale, which includes the Glasgow Coma Scale (GCS) and 3 picture cards used to measure amnesia, in identifying the presence or absence of posttraumatic amnesia in individuals with mild traumatic brain injury (mTBI).DESIGN: Prospective study using data from the Abbreviated Westmead Post-traumatic Amnesia Scale.SETTING: Trauma hospital.PARTICIPANTS: Individuals with possible mTBI who presented between April and September 2011 (N=252; age range, 18-65y; mean age, 37.4±13.9y; 77{\%} men).INTERVENTION: Administration of the Abbreviated Westmead Post-traumatic Amnesia Scale.MAIN OUTCOME MEASURES: GCS and Abbreviated Westmead Post-traumatic Amnesia Scale pass/fail rates.RESULTS: Of the individuals, 169 (mean age, 35.1±13.6y; 77{\%} men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89-205min) after triage. Of the 45 who failed, 31 (69{\%}) had a GCS score of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95{\%} confidence interval [CI], 1.02-1.06; P<.05), having consumed alcohol (OR, 3.09; 95{\%} CI, 1.42-6.74; P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95{\%} CI, 0.99-1.00; P<.05). Nineteen (42{\%}) of those who failed had consumed alcohol, 11 had a GCS score of 15, and 8 had a GCS score of 14.CONCLUSIONS: A GCS score of 15 does not always signify return to normative cognitive function. Individuals with a GCS score of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the Abbreviated Westmead Post-traumatic Amnesia Scale will assist in making a diagnosis of mTBI.",
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Identifying posttraumatic amnesia in individuals with a Glasgow Coma Scale of 15 after mild traumatic brain injury. / Meares, Susanne; Shores, E. Arthur; Smyth, Tracy; Batchelor, Jennifer; Murphy, Margaret; Vukasovic, Matthew.

In: Archives of Physical Medicine and Rehabilitation, Vol. 96, No. 5, 56074, 01.05.2015, p. 956-959.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Identifying posttraumatic amnesia in individuals with a Glasgow Coma Scale of 15 after mild traumatic brain injury

AU - Meares, Susanne

AU - Shores, E. Arthur

AU - Smyth, Tracy

AU - Batchelor, Jennifer

AU - Murphy, Margaret

AU - Vukasovic, Matthew

PY - 2015/5/1

Y1 - 2015/5/1

N2 - OBJECTIVE: To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale, which includes the Glasgow Coma Scale (GCS) and 3 picture cards used to measure amnesia, in identifying the presence or absence of posttraumatic amnesia in individuals with mild traumatic brain injury (mTBI).DESIGN: Prospective study using data from the Abbreviated Westmead Post-traumatic Amnesia Scale.SETTING: Trauma hospital.PARTICIPANTS: Individuals with possible mTBI who presented between April and September 2011 (N=252; age range, 18-65y; mean age, 37.4±13.9y; 77% men).INTERVENTION: Administration of the Abbreviated Westmead Post-traumatic Amnesia Scale.MAIN OUTCOME MEASURES: GCS and Abbreviated Westmead Post-traumatic Amnesia Scale pass/fail rates.RESULTS: Of the individuals, 169 (mean age, 35.1±13.6y; 77% men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89-205min) after triage. Of the 45 who failed, 31 (69%) had a GCS score of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.06; P<.05), having consumed alcohol (OR, 3.09; 95% CI, 1.42-6.74; P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95% CI, 0.99-1.00; P<.05). Nineteen (42%) of those who failed had consumed alcohol, 11 had a GCS score of 15, and 8 had a GCS score of 14.CONCLUSIONS: A GCS score of 15 does not always signify return to normative cognitive function. Individuals with a GCS score of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the Abbreviated Westmead Post-traumatic Amnesia Scale will assist in making a diagnosis of mTBI.

AB - OBJECTIVE: To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale, which includes the Glasgow Coma Scale (GCS) and 3 picture cards used to measure amnesia, in identifying the presence or absence of posttraumatic amnesia in individuals with mild traumatic brain injury (mTBI).DESIGN: Prospective study using data from the Abbreviated Westmead Post-traumatic Amnesia Scale.SETTING: Trauma hospital.PARTICIPANTS: Individuals with possible mTBI who presented between April and September 2011 (N=252; age range, 18-65y; mean age, 37.4±13.9y; 77% men).INTERVENTION: Administration of the Abbreviated Westmead Post-traumatic Amnesia Scale.MAIN OUTCOME MEASURES: GCS and Abbreviated Westmead Post-traumatic Amnesia Scale pass/fail rates.RESULTS: Of the individuals, 169 (mean age, 35.1±13.6y; 77% men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89-205min) after triage. Of the 45 who failed, 31 (69%) had a GCS score of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.06; P<.05), having consumed alcohol (OR, 3.09; 95% CI, 1.42-6.74; P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95% CI, 0.99-1.00; P<.05). Nineteen (42%) of those who failed had consumed alcohol, 11 had a GCS score of 15, and 8 had a GCS score of 14.CONCLUSIONS: A GCS score of 15 does not always signify return to normative cognitive function. Individuals with a GCS score of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the Abbreviated Westmead Post-traumatic Amnesia Scale will assist in making a diagnosis of mTBI.

KW - Amnesia

KW - anterograde

KW - Brain injuries

KW - Rehabilitation

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DO - 10.1016/j.apmr.2014.12.014

M3 - Article

VL - 96

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EP - 959

JO - Archives of Physical Medicine and Rehabilitation

T2 - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 5

M1 - 56074

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