A Retrospective Review on Post Traumatic Agitation Predictors in Hospitalized Patients with Acute Traumatic Brain Injury
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Keywords

Traumatic Brain Injury, Post-Traumatic agitation, Acute Care, Predictors, Outcome.

How to Cite

Jehane H. Dagher, Jennifer Massad, Julie Lamoureux, Elaine de Guise, & Mitra Feyz. (2019). A Retrospective Review on Post Traumatic Agitation Predictors in Hospitalized Patients with Acute Traumatic Brain Injury. Journal of Basic & Applied Sciences, 15, 106–113. https://doi.org/10.29169/1927-5129.2019.15.13

Abstract

Objectives: To determine if socio-demographic, medical and radiological variables have an impact on the risk of developing post-traumatic agitation in patients with mild complex to severe Traumatic Brain Injury (TBI). In addition, determine prognosis using the Extended Glasgow Outcome Scale (GOS-E), length of stay (LOS) and orientation at discharge of agitated patients with TBI.
Methods: A retrospective observational study of all 778 patients admitted to the Montreal General Hospital, a tertiary specialized trauma centre, following a TBI that occurred between 2013 and 2015. Data was collected from the national trauma registry and TBI program database. Independent variables collected were socio-demographic, clinical, and neurological information. Dependent variables were LOS in days, non-pharmacological treatment, GOS-E at discharge, and discharge destination.
Results: 55 patients (7.1%) suffered from post-traumatic agitation. The group with agitation had a significantly higher proportion of men, psychiatric history and suffered in a greater proportion a moderate TBI. The median GCS was significantly lower and post traumatic amnesia was longer in subjects with agitation. A higher percentage of patients with agitation were transferred to long-term care (LTC) facilities.

https://doi.org/10.29169/1927-5129.2019.15.13
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References

Saoût V, Gambart G, Leguay D, Ferrapie AL, Launay C, Richard I. Agressive behavior after traumatic brain injury. Ann Phys Rehabil Med 2011. https://doi.org/10.1016/j.rehab.2011.04.003

Stéfan A, Mathé JF, Dhenain M, et al. What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices. Ann Phys Rehabil Med 2016. https://doi.org/10.1016/j.rehab.2015.11.002

Faul M, Xu L, Wald MM, Coronado V, Dellinger AM. Traumatic brain injury in the United States: national estimates of prevalence and incidence, 2002-2006. Inj Prev 2010. https://doi.org/10.1136/ip.2010.029215.951

Chew E, Zafonte RD. Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review. J Rehabil Res Dev 2009. https://doi.org/10.1682/JRRD.2008.09.0120

Bhatnagar S, Iaccarino MA, Zafonte R. Pharmacotherapy in rehabilitation of post-acute traumatic brain injury. Brain Res 2016. https://doi.org/10.1891/9781617052699.0051

Ponsford J, Janzen S, McIntyre A, Bayley M, Velikonja D, Tate R. INCOG Recommendations for management of cognition following traumatic brain injury, Part I: Posttraumatic amnesia/delirium. J Head Trauma Rehabil 2014. https://doi.org/10.1097/HTR.0000000000000074

Singh R, Venkateshwara G, Nair KPS, Khan M, Saad R. Agitation after traumatic brain injury and predictors of outcome. Brain Inj 2014. https://doi.org/10.3109/02699052.2013.873142

McNett M, Sarver W, Wilczewski P. The prevalence, treatment and outcomes of agitation among patients with brain injury admitted to acute care units. Brain Inj 2012. https://doi.org/10.3109/02699052.2012.667587

Wolffbrandt MM, Poulsen I, Engberg AW, Hornnes N. Occurrence and severity of agitated behavior after severe traumatic brain injury. Rehabil Nurs 2013. https://doi.org/10.1002/rnj.82

Arciniegas DB, McAllister TW. Neurobehavioral Management of Traumatic Brain Injury in the Critical Care Setting. Crit Care Clin 2008. https://doi.org/10.1016/j.ccc.2008.06.001

Corrigan JD. Development of a scale for assessment of agitation following traumatic brain injury. J Clin Exp Neuropsychol 1989. https://doi.org/10.1080/01688638908400888

Jennett B. Development of Glasgow Coma and Outcome Scales. Nepal J Neurosci 2005. https://doi.org/10.3126/njn.v2i1.19978

Marshall LF, Bowers Marshall S, Klauber MR, et al. A new classification of head injury based on computerized tomography. J Neurosurg 1991. https://doi.org/10.3171/sup.1991.75.1s.0s14

Copes WS, Champion HR, Sacco WJ, Lawnick MM, Keast SL, Bain LW. The Injury Severity Score Revisited. J Trauma Inj Infect Crit Care 1988. https://doi.org/10.1097/00005373-198801000-00010

Baker SP, O’Neill B, Haddon W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974. https://doi.org/10.1097/00005373-197403000-00001

Salottolo K, Settell A, Uribe P, et al. The impact of the AIS 2005 revision on injury severity scores and clinical outcome measures. Injury 2009. https://doi.org/10.1016/j.injury.2009.05.013

Wilson JTL, Pettigrew LEL, Teasdale GM. Structured Interviews for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for Their Use. J Neurotrauma 1998. https://doi.org/10.1089/neu.1998.15.573

Jennett B, Snoek J, Bond MR, Brooks N. Disability after severe head injury: Observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry 1981. https://doi.org/10.1136/jnnp.44.4.285

Levin HS, O’Donnell VM, Grossman RG. The galveston orientation and amnesia test a practical scale to assess cognition after head injury. J Nerv Ment Dis 1979. https://doi.org/10.1037/t28509-000

Furbringer e Silva SC, de Sousa RMC. Galveston Orientation and Amnesia Test: applicability and relation with the Glasgow Coma Scale. Rev Lat Am Enfermagem 2007; 15(4): 651-657. https://doi.org/10.1590/S0104-11692007000400020

Rao V, Rosenberg P, Bertrand M, et al. Aggression After Traumatic Brain Injury: Prevalence and Correlates. J Neuropsychiatry Clin Neurosci 2009. https://doi.org/10.1176/jnp.2009.21.4.420

Bogner J, Barrett RS, Hammond FM, et al. Predictors of Agitated Behavior During Inpatient Rehabilitation for Traumatic Brain Injury. Arch Phys Med Rehabil 2015.

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Copyright (c) 2019 Jehane H. Dagher, Jennifer Massad, Julie Lamoureux, Elaine de Guise , Mitra Feyz