Prediction of Cognitive Abilities 1 Year Following Traumatic Brain Injury From Inpatient Rehabilitation Cognitive Screening

Past Studies

Past Studies have shown that persons sustaining a TBI have cognitive deficits that impact the rehabilitation process. Neuropsychological evaluation cannot always be performed during acute rehabilitation because of the severity of the person’s injury. Brief screening instruments that can be performed at bedside are needed to document progress in a valid and reliable fashion.

This Study

This Study involved 50 individuals with TBI in an acute rehabilitation facility that is part of a large university medical center. Thirty-three of the patients were men; 17 were women. Most of the patients were moderately or severely impaired as a result of their injury; the average age was 35.2 years; average education was 12.2 years. The two tools used in this study, the Cognitive-Log (COG-Log) which measures cognitive functioning ( memory , praxis and executive functioning) and the Orientation-Log (O-Log) which measures orientation, were brief bedside assessments done during daily patient rounds. These instruments have already been shown to be reliable. The present study focused on the validity of the instruments by showing that performance on the COG-Log and O-Log were predictive of outcome 1 year after injury based on neuropsychological evaluation.

Findings are not intended to suggest that the brief screening should replace a full neuropsychological assessment when such an assessment can be completed. However, the O-Log and COG-Log can be used to document cognitive progress and thus assist in developing discharge plans. In addition to their usefulness in the acute rehabilitation process, the COG-Log and O-Log were found to be helpful in determing a patient’s thinking abilities at 1 year post-injury.

Who May Be Affected By These Findings

Persons with brain injury and their families, caregivers, community providers, community health professionals.

Caveats

It would be helpful if a relationship between O-Log and COG-Log performance and functional outcome (such as need for supervision and community integration) could be established, as well. The sample size was small. It had a finite number of variables (age, gender, education, severity of injury) suggesting that this study may have merits using a larger number of participants.

Bottom Line

The Cognitive-Log (COG-Log) was significant predictor of outcome 1 year post-injury in the areas of attention, executive functioning and visiospatial abilities. The Orientation Log (O-Log) predicted outcomes in the area of memory. Used together, correct prediction of cognitive outcome was high.

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