Relationships between neuropsychological impairments and functional outcome eight years after severe traumatic brain injury: Results from the PariS-TBI study,Brain Injury

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Relationships between neuropsychological impairments and functional outcome eight years after severe traumatic brain injury: Results from the PariS-TBI study
Brain Injury ( IF 1.9 ) Pub Date : 2021-07-20 , DOI: 10.1080/02699052.2021.1933180
Claire Vallat-Azouvi _{1,

2,

3} , Marie Swaenepoël ₂ , Alexis Ruet ₄ , Eleonore Bayen ₅ , Idir Ghout ₆ , Gaelle Nelson ₇ , Pascale Pradat-Diehl ₅ , Layide Meaude ₆ , Philippe Aegerter ₆ , James Charanton ₇ , Claire Jourdan ₈ , Philippe Azouvi _{3,

9}

Affiliation

UR Fonctionnement et Dysfonctionnement Cognitifs : les âges de la vie (DYSCO), Université Paris 8-Saint-Denis, Saint-Denis, France.
Antenne UEROS- UGECAM IDF, Hôpital Raymond Poincaré, Garches, France.
Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.
Centre Hospitalier Universitaire De Caen, Service De Médecine Physique Et De Réadaptation, Caen, France.
Assistance Publique-Hôpitaux De Paris, Groupe Hospitalier Pitié-Salpêtrière, Service De Médecine Physique Et Réadaptation, Paris, and Paris Sorbonne Université, Paris, France.
Assistance Publique-Hôpitaux De Paris, Hôpital Ambroise Paré, Unité De Recherche Clinique (URC), Boulogne, France.
Centre Ressources Francilien Du Traumatisme Crânien (CRFTC), Paris, France.
Centre Hospitalier Universitaire De Montpellier, Service De Médecine Physique Et De Réadaptation, Montpellier, France.
Assistance Publique-Hôpitaux De Paris, Hôpital Raymond Poincaré, Service De Médecine Physique Et De Réadaptation, Garches, France.

ABSTRACT

Background/objectives

The objective was to assess the relationships between neuropsychological impairments, functional outcome and life satisfaction in a longitudinal study of patients after a severe traumatic brain injury (TBI) (PariS-TBI study).

Patients

Out of 243 survivors, 86 were evaluated 8 years post-injury. They did not significantly differ from patients lost-to-follow up except for the latter being more frequently students or unemployed before the injury.

Methods

Outcome measures included the Glasgow Outcome Scale-Extended (GOS-E), a functional independence questionnaire, employment, mood, fatigue and satisfaction with life. Neuropsychological outcome was assessed by two ways: performance-based outcome measures, using neuropsychological tests and patient and relative-based measures.

Results

Neuropsychological measures were not significantly related to initial injury severity nor to gender, but were significantly related to age and education. After statistical correction for multiple comparisons, cognitive testing and cognitive questionnaires were significantly correlated with most outcome measures. By contrast, satisfaction with life was only related with patient-rated questionnaires. A regression analysis showed that the Trail-Making-Test-A was the best predictor of functional outcome, in addition to education duration.

Conclusions

Cognitive measures, particularly slowed information processing speed, were significant indicators of functional outcome at a long-term post-injury, beyond and above demographics or injury severity measures.

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