頭部外傷病患急性期認知功能評估對初期預後之預測效力探討

陳淑滿

doi:10.6834/CSMU.2010.00034

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頭部外傷病患急性期認知功能評估對初期預後之預測效力探討

Cognitive Function Evaluation in Acute Phase of Traumatic Brain Injury to Predict the Patients’Preliminary Prognosis

陳淑滿 , Masters　　Advisor：陳玉如;廖玟君　　

繁體中文 DOI： 10.6834/CSMU.2010.00034

頭部外傷；認知功能；功能性預後；預測效力； traumatic brain injury ； cognitive function ； functional outcome ； predictive validity.

Abstract │ Reference (55) │ Altmetrics

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Traumatic brain injury related morbidity and mortality gradually exceed other diseases in recent years. Among the morbidities, cognitive impairment can lead to a longer disable period than physical impairment. In this study, we investigated whether cognitive function evaluation in the acute phase was predictive of functional outcome. This is a prospective and descriptive study which enrolled 77 traumatic brain injury patients, including 52 mild and 25 moderate-severe injuries, by purposeful sampling in a regional teaching hospital from 15 August 2009 to 15 February 2010. Structural evaluation, including Glasgow Coma Scale (GCS), Rancho Los Amigos levels of cognitive function Scale (RLAS), Galveston Orientation and Amnesia Test (GOAT), of each patient will be recorded by interviews and observations on the day of admission and the day of discharge. Glasgow Outcome Scale - Extended (GOSE) was used to evaluate the functional outcome 3 months after the injury. After gathering the data, statistical analysis was processed by SPSS 17.0 software for mild and moderate-severe traumatic brain injury patients. Descriptive statistical analysis includes frequency-distribution, percentage, mean, and standard deviation; inferential statistics analysis includes paired-samples t test, simple regression, and multiple regression.
The result of this study indicated that age was related to the outcome. After adjusting for the factor of age, the addition of GOAT or RLAS on the day of admission and the day of discharge increases predictive value of the 3 months functional outcome in patients with mild traumatic brain injury. However, only GCS on the day of discharge was predictive, in the group of moderate-severe traumatic brain injury patients. We recommend including RLAS and GOAT to the routine evaluation for patients of traumatic brain injury, which can offer additional information to medical groups and to know potential cognitive defects and possible preliminary outcome for the family and for discharge plans.

Reference ( 55 ) 〈TOP〉

王雅玲、黃崇謙、楊啟賢(2006)•頭部外傷原因與醫療資源耗用•北市醫學雜誌，3(11)，53-64。
連結：
林家瑋、蔡宛真、邱文達、林天仁、江培業、林乾閔等(2004)•台灣地區外傷性顱內出血之研究•Journal of Emergence Critical Care Medicine, 15(1), 20-28.
連結：
邱艷芬(2000)•從腦灌流壓與腦組織的存活談頭部外傷病人的護理•護理雜誌，47(3)，59-63。
連結：
紀煥庭、邱文達、楊大羽、蔡行瀚(2007)•輕度頭部外傷之分類及危險因子•Journal of Emergence Critical Care Medicine, 19(2), 31-38。
連結：
Akio, k.(2003). The current status and problems of rehabilitation for TBI (Traumatic brain injury) patient in Japan. Keio Journal of Medicine, 52(2),100-106.
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