Watson C E, Clous E A, Jaeger M, D'Amours S K
1 Occupational Therapy Department, Liverpool Hospital, Liverpool, NSW, Australia.
2 Trauma Department, Liverpool Hospital, Liverpool, NSW, Australia.
Scand J Surg. 2017 Dec;106(4):356-360. doi: 10.1177/1457496917698642. Epub 2017 Apr 7.
Mild traumatic brain injury is a common presentation to Emergency Departments. Early identification of patients with cognitive deficits and provision of discharge advice are important. The Abbreviated Westmead Post-traumatic Amnesia Scale provides an early and efficient assessment of post-traumatic amnesia for patients with mild traumatic brain injuries, compared with the previously used assessment, the Modified Oxford Post-traumatic Scale.
This retrospective cohort study reviewed 270 patients with mild traumatic brain injury assessed for post-traumatic amnesia over a 2-year period between February 2011 and February 2013. It identified those assessed with Abbreviated Westmead Post-traumatic Amnesia Scale versus Modified Oxford Post-traumatic Scale, the outcomes of these post-traumatic amnesia assessments, the hospital length of stay for patients, and their readmission rates.
The Abbreviated Westmead Post-traumatic Amnesia Scale was used in 91% of patient cases (and the Modified Oxford Post-traumatic Scale in 7%), and of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 94% cleared post-traumatic amnesia testing within 4 h. Of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 56% had a shorter length of stay than had they been assessed with the Modified Oxford Post-traumatic Scale, resulting in 295 bed-days saved. Verbal and written discharge advice was provided to those assessed for post-traumatic amnesia to assist their recovery. In all, 1% of patients were readmitted for monitoring of mild post-concussion symptoms.
The Abbreviated Westmead Post-traumatic Amnesia Scale provides an effective and timely assessment of post-traumatic amnesia for patients presenting to the Emergency Department with mild traumatic brain injury compared with the previously used assessment tool. It helps identify patients with cognitive impairment and the need for admission and further investigation, resulting in appropriate access to care. It also results in a decreased length of stay and decreased hospital admissions, with subsequent cost savings to the hospital.
轻度创伤性脑损伤是急诊科常见的病症表现。早期识别有认知缺陷的患者并提供出院建议至关重要。与先前使用的改良牛津创伤后量表相比，简化版韦斯特米德创伤后遗忘量表能对轻度创伤性脑损伤患者的创伤后遗忘进行早期且有效的评估。
这项回顾性队列研究对2011年2月至2013年2月期间接受创伤后遗忘评估的270例轻度创伤性脑损伤患者进行了回顾。研究确定了使用简化版韦斯特米德创伤后遗忘量表与改良牛津创伤后量表进行评估的患者、这些创伤后遗忘评估的结果、患者的住院时间及其再入院率。
91%的患者病例使用了简化版韦斯特米德创伤后遗忘量表（7%使用了改良牛津创伤后量表），在使用简化版韦斯特米德创伤后遗忘量表进行评估的患者中，94%在4小时内通过了创伤后遗忘测试。在使用简化版韦斯特米德创伤后遗忘量表进行评估的患者中，56%的住院时间比使用改良牛津创伤后量表评估时更短，节省了295个床位日。为接受创伤后遗忘评估的患者提供了口头和书面出院建议以帮助其康复。总体而言，1%的患者因监测轻度脑震荡后症状而再次入院。
与先前使用的评估工具相比，简化版韦斯特米德创伤后遗忘量表能对急诊科就诊的轻度创伤性脑损伤患者的创伤后遗忘进行有效且及时的评估。它有助于识别有认知障碍以及需要入院和进一步检查的患者，从而实现适当的医疗救治。它还能缩短住院时间并减少医院入院人数，进而为医院节省成本。
