To describe the cognitive profile of acute, hospitalized mTBI patients, and associations with functional outcomes at 6 months post-injury.

The best method of identifying mTBI patients at risk of developing a persistent post-concussive syndrome, particularly during the acute post-injury phase, is a matter of ongoing research.  At UC Davis, mTBI patients admitted to the hospital are administered a novel screener, the UCD-Cog, which is based on the speech pathology department’s experience with the Cognistat Cognitive Assessment and evaluates the patient on 16 aspects of cognition and behavior.  We present the UCD-Cog cognitive profile of hospitalized mTBI patients and associated functional outcomes at 6 months.

345 TBI patients who were evaluated by the UC Davis Neurosurgery Department over a 1-year period met the inclusion criteria of age >= 18 years, Glasgow Coma Score (GCS) 13-15, and participation in inpatient UCD-Cog evaluation and 6-month outpatient follow-up.  Associations between UCD-Cog performance and 6-month Glasgow Outcome Scale-Extended (GOSE) scores were assessed by nonparametric Kruskal-Wallis Tests (KWT) with Bonferroni Correction.  We also evaluated for associations between age, GCS, gender, CT-Head abnormalities, mechanism-of-injury, and UCD-Cog performance.

UCD-Cog performance on 7 of 16 measures (orientation, attention, immediate-recall, delayed-recall, autobiographic memory, executive function, processing speed) were associated with significant differences in 6-month GOSE scores (χ²(7) = 35.1, p < 0.00001, n = 345). mTBI patients with impairments in more than 5 of these 7 measures reported a 2-point lower GOSE than those with zero impaired measures (4.2 vs 6.5, post-hoc Dunn’s Test, p.adj < 0.01). Only GCS and age showed significant differences with UCD-Cog performance (KWT, p.adj < 0.001).

UCD-Cog may assist with early identification of cognitive deficits associated with worse mTBI outcomes.  Patients with impairments on greater than 5 of 7 select UCD-Cog measures may be at risk for persistent post-concussive syndrome.