Traumatology Program, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Québec; Department of Psychology, Université du Québec à Montréal, Montréal, Québec.
Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Québec; Faculty of Medicine, Université Laval, Québec.
Arch Phys Med Rehabil. 2022 Nov;103(11):2131-2137. doi: 10.1016/j.apmr.2022.02.015. Epub 2022 Mar 17.
To determine how results on the EXAmen Cognitif abrégé en Traumatologie (EXACT), a new test specifically designed to briefly assess global cognitive functioning during the acute phase of traumatic brain injury (TBI), can predict long-term functional outcome compared with length of posttraumatic amnesia (PTA), a well-established predictor.
Inception cohort.
Level 1 trauma center.
A total of 90 patients (N=90) hospitalized for a moderate or severe TBI.
Not applicable.
Performance on the EXACT in the first 3 months after injury and results on the Disability Rating Scale (DRS) at follow-up 1-2 years later.
EXACT scores were all correlated with length of PTA and DRS result. Compared with length of PTA, the EXACT added significantly to the regression and improved prediction of functional outcome. More specifically, a total score ≤80 on the EXACT was associated with a higher rate of long-term disability because of more severe TBI consequences. Behavioral regulation and executive functions were the cognitive domains that showed the most impairment, followed by attention and working memory as well as episodic memory. Except for length of PTA and hospital stay, the DRS score was not correlated with other demographic (age, education) or clinical variables (Glasgow Coma Scale and maximum score on the Therapy Intensity Level Scale).
The EXACT can be administered to most patients early in the acute phase of TBI, and results could be used, along with other predictors such as PTA, to estimate their long-term functional sequelae. The EXACT may be a promising brief cognitive instrument for future studies investigating recovery after TBI.
确定专门设计用于在创伤性脑损伤（TBI）急性期内简要评估整体认知功能的新测试 EXAmen Cognitif abrégé en Traumatologie（EXACT）的测试结果与广为认可的预测指标创伤后遗忘时间（PTA）相比，如何预测长期功能预后。
创始队列研究。
1 级创伤中心。
共纳入 90 例因中度或重度 TBI 住院的患者（N=90）。
无。
伤后 3 个月内 EXACT 测试的表现，以及 1-2 年后随访时的残疾评定量表（DRS）结果。
EXACT 评分均与 PTA 长度和 DRS 结果相关。与 PTA 长度相比，EXACT 显著增加了回归并改善了功能预后的预测。更具体地说，EXACT 总分≤80 与更严重的 TBI 后果相关，导致长期残疾的发生率更高。行为调节和执行功能是认知领域受损最严重的，其次是注意力和工作记忆以及情景记忆。除 PTA 和住院时间外，DRS 评分与其他人口统计学（年龄、教育）或临床变量（格拉斯哥昏迷量表和治疗强度水平量表的最大评分）均无相关性。
EXACT 可在 TBI 急性期内尽早应用于大多数患者，并且可以与 PTA 等其他预测因素一起，用于估计其长期功能后果。EXACT 可能是未来研究 TBI 后恢复的一种有前途的简短认知工具。
