Background:The assessment of patients with mild traumatic brain injury (mTBI) is predominantly done using the Glasgow Coma Scale (GCS). While the GCS is a universally accepted for assessment of severity of TBI, it may not be appropriate to rely on the GCS alone when assessing patients with mTBI in pre-hospital settings and Emergency Departments.
Objective: To determine whether administering the Revised Westmead PTA Scale (R-WPTAS) in addition to the GCS would increase diagnostic accuracy in the early identification of cognitive impairment in patients with mTBI.
Methods: Data were collected from 82 consecutive participants with mTBI who presented to the emergency department of a Level 1 trauma centre in Australia. A matched sample of 88 control participants who attended the emergency department for reasons other than head trauma was also assessed. All patients were assessed using the GCS, the R-WPTAS and a battery of neuropsychological tests.
Results: Patients with mTBI scored poorly compared to control patients on all measures. The R-WPTAS showed greater concurrent validity with the neuropsychological measures than the GCS and significantly increased prediction of group membership of patients with mTBI with cognitive impairment.
Conclusions: The R-WPTAS significantly improves diagnostic accuracy in identifying patients with mTBI who may be in PTA. Administration takes less than one minute, and since early identification of a patient’s cognitive status facilitates management decisions, it is recommended for routine use whenever the GCS is used.
- Glasgow Coma Scale
- Westmead PTA Scale
- mild traumatic brain injury
- post-traumatic amnesia
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