Cognitive reserve index and long-term disability in patients with severe traumatic brain injury discharged from the intensive rehabilitation unit

Frontiers in Neurology

Neurology

Bahia Hakiki¹  Daniela Maccanti¹  Anna Maria Romoli¹  Andrea Mannini¹  Francesca Draghi¹  Silvia Pancani¹  Francesca Cecchi² 

[1] IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy;IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy;Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy;

关键词: traumatic brain injury;    cognitive reserve;    functional status;    rehabilitation;    disability;   

DOI  :  10.3389/fneur.2023.1106989

 received in 2022-11-24, accepted in 2023-03-21,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesThe “cognitive reserve” (CR) theory posits that higher premorbid cognitive activities can mitigate the effects of brain damage. This study aimed to investigate the association between CR and long-term functional autonomy in patients surviving a severe traumatic brain injury (sTBI).SettingData were collected from the database of inpatients with severe acquired brain injury in a rehabilitation unit admitted from August 2012 to May 2020.ParticipantsPatients that had incurred an sTBI, aged 18+ years, completing the phone Glasgow Outcome Scale-Expanded at follow-up (pGOS-E) in absence of previous brain trauma or neurological disease, or cognitive disorders were included. Patients with severe brain injury from non-traumatic etiologies were not included in the study.DesignIn this longitudinal study, all patients underwent a multidimensional assessment including the cognitive reserve index questionnaire (CRIq), the coma recovery scale-revised, the level of cognitive functioning, the Disability Rating Scale (DRS), and the Galveston Orientation and Amnesia Test at admission. At discharge, functional scales were administered again together with the Glasgow Outcome Scale. The pGOS-E was assessed at follow-up.Main measurespGOS-E.ResultsA total of 106 patients/caregivers underwent the pGOS-E after 5.8 [3.6] years from the event. Among them, 46 (43.4%) died after discharge, and 60 patients [men: 48 (80%); median age: 54 years; median time post-onset: 37 days; median education level: 10 years; median CRIq total score: 91] were included in the analysis exploring the association between pGOS-E and demographic data, cognitive reserve surrogates, and clinical variables at admission and discharge from the rehabilitation unit. A younger age (B = −0.035, p = 0.004) and a lower DRS category at discharge (B = −0.392, p = 0.029) were significantly related to a higher long-term functional autonomy in the multivariate analysis.ConclusionLong-term functional autonomy was not influenced by CR as assessed through the educational level and the CRIq.

【 授权许可】

Unknown   
Copyright © 2023 Hakiki, Pancani, Romoli, Draghi, Maccanti, Mannini and Cecchi.