Résumé
Objectives:To investigate the factors related to the long-term outcome for patients after severe traumatic brain injury. Methods:From January, 2015 to December, 2018, 135 patients with severe traumatic brain injury were selected. Their gender, age (of onset), education level, injury sites, and lesion side were recorded, and they were assessed with Disability Rating Scale (DRS), Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA) for motor and balance and modified Barthel Index (MBI). They were assessed with DRS again one year after discharge. Results:The age (r = 0.188), early DRS score (r = 0.530), MMSE score (r = -0.376), FMA for motor (r = -0.284) and balance (r = -0.425) score, MBI score (r = -0.480), brain stem injury (r = 0.194) and diffuse brain injury (r = 0.202) were related to DRS scores as follow-up (P < 0.05); while, the gender (r = -0.175), early DRS score (r = 0.586), MMSE score (r = -0.242), FMA for motor (r = -0.301) and balance (r = -0.228) score, MBI score (r = -0.367) and occipital lobe injury (r = 0.209) were related to difference of DRS (P < 0.05). Conclusion:The age, early cognitive and motor dysfunction are related with the outcome of one year of patients after severe traumatic brain injury. More researches are needed to explore the impact of injury sites on the outcome.
Résumé
<p><b>PURPOSE</b>To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in patients with chronic traumatic brain injury (TBI) or stroke and to evaluate the sensitivity of the two scales in patients with TBI.</p><p><b>METHODS</b>In this cohort study, a total of 230 patients were evaluated, including TBI group (n = 103) and stroke group (n = 127). The cognitive functions of two groups were evaluated by designated specialists using MoCA (Beijing version) and MMSE (Chinese version).</p><p><b>RESULTS</b>Comparedwith the patientswith stroke, the patientswith TBI received significantly lower score in orientation subtest and recall subtest in both tests.MoCA abnormal rates in the TBI group and stroke group were 94.17% and 86.61% respectively,whileMMSE abnormal rateswere 69.90% and 57.48%, respectively. In the TBI group, 87.10% patientswith normalMMSE score had abnormalMoCA score and in the stroke group, about 70.37% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, respectively.</p><p><b>CONCLUSION</b>In our rehabilitation center, patients with TBI may have more extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post- TBI cognitive impairment, MoCA tends to be more sensitive than MMSE.</p>