Early cognitive status and productivity outcome after traumatic brain injury

Findings from the TBI model systems

Mark Sherer, Angelle M. Sander, Todd G. Nick, Walter M. High, James F. Malec, Mitchell Rosenthal

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

Objective: To evaluate the contribution of early cognitive assessment to the prediction of productivity outcome after traumatic brain injury (TBI) adjusted for severity of injury, demographic factors, and preinjury employment status. Design: Inception cohort. Setting: Six inpatient brain injury rehabilitation programs. Participants: A total of 388 adults with TBI whose posttraumatic amnesia (PTA) resolved before discharge from inpatient rehabilitation. Interventions: Administered neuropsychologic tests during inpatient stay on emergence from PTA. Follow-up interview and evaluation. Predictor measures also determined. Main Outcome Measure: Productivity status at follow-up 12 months postinjury. Results: Multiple logistic regression analysis revealed that preinjury productivity status, duration of PTA, education level, and early cognitive status each made significant, independent contributions to the prediction of productivity status at follow-up. When adjusted for all other predictors, persons scoring at the 75th percentile on early cognitive status (less impaired) had 1.61 times greater odds (95% confidence interval [CI], 1.07-2.41) of being productive follow-up than those scoring at the 25th percentile (more impaired). Without adjustment, persons scoring at the 75th percentile had 2.46 times greater odds (95% CI, 1.77-3.43) of being productive at follow-up. Conclusions: Findings support the utility of early cognitive assessment by using neuropsychologic tests. In addition to other benefits, early cognitive assessment makes an independent contribution to prediction of late outcome. Findings support the clinical practice of performing initial neuropsychologic evaluations after resolution of PTA.

Original languageEnglish (US)
Pages (from-to)183-192
Number of pages10
JournalArchives of Physical Medicine and Rehabilitation
Volume83
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

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Amnesia
Inpatients
Neuropsychological Tests
Rehabilitation
Confidence Intervals
Social Adjustment
Brain Injuries
Logistic Models
Regression Analysis
Demography
Outcome Assessment (Health Care)
Interviews
Education
Traumatic Brain Injury
Wounds and Injuries

Keywords

  • Brain injuries
  • Cognition disorders
  • Employment
  • Neuropsychological tests
  • Rehabilitation
  • Treatment outcome

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Early cognitive status and productivity outcome after traumatic brain injury : Findings from the TBI model systems. / Sherer, Mark; Sander, Angelle M.; Nick, Todd G.; High, Walter M.; Malec, James F.; Rosenthal, Mitchell.

In: Archives of Physical Medicine and Rehabilitation, Vol. 83, No. 2, 2002, p. 183-192.

Research output: Contribution to journalArticle

Sherer, Mark ; Sander, Angelle M. ; Nick, Todd G. ; High, Walter M. ; Malec, James F. ; Rosenthal, Mitchell. / Early cognitive status and productivity outcome after traumatic brain injury : Findings from the TBI model systems. In: Archives of Physical Medicine and Rehabilitation. 2002 ; Vol. 83, No. 2. pp. 183-192.
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