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Multidimensional assessment of acute confusion after traumatic brain injury
SHERER M; NAKASE THOMPSON R; YABLON SA; GONTKOVSKY ST
ARCH PHYS MED REHABIL , 2005, vol. 86, n° 5, p. 896-904 Doc n°: 120995 Localisation : Documentation IRR Descripteurs : AF3 - TRAUMATISME CRANIEN
Article consultable sur : http://www.archives-pmr.org
Objectives: To describe the phenomenology of posttraumatic confusional state (PTCS) and to provide preliminary validation of a new procedure, the Confusion Assessment Protocol (CAP), for assessing PTCS. Design: Criterion standard investigation. Setting: Inpatient traumatic brain injury (TBI) rehabilitation program. Participants: Two consecutive series of patients (n=62, n=93) with TBI admitted for inpatient rehabilitation. Interventions: Not applicable. Main Outcome Measures: Clinical diagnosis of delirium based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, classification of posttraumatic amnesia (PTA) based on the Galveston Orientation and Amnesia Test (GOAT), and Disability Rating Scale score at time of rehabilitation hospital discharge. Results: Agreement between the diagnosis of PTCS with the CAP and DSM-IV classification of delirium was 87%, and agreement between PTCS and PTA using GOAT criteria was 90%. Patients classified as in PTCS sustained more severe injuries and required longer rehabilitation stays. Confusion status was associated with poorer functional status at rehabilitation discharge. Conclusions: The CAP is a brief, structured, repeatable measure of multiple neurobehavioral aspects of PTCS. Confusion status as determined by CAP assessment contributed to prediction of outcome at rehabilitation discharge after adjustment for other potential predictors. © 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Langue : ANGLAIS |
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