Face-to-Face Versus Telephonic Extended Glasgow Outcome Score Testing After Traumatic Brain Injury

INTRODUCTION - Traumatic brain injury [TBI] most affects the working population and their earning capacity. The various sub categories of TBI in terms of clinical features,Glasgow coma scale [GCS] and radiology are well defined.We have attempted an analysis in terms of long term Glasgow outcome score [GOS] and tried to correlate with the various factors of TBI. MATERIALS AND METHODS – All patients of TBI over 12 years and below 60 years and those without other major trauma were included over a period of about two years. The clinical features, presentation GCS, treatment given, and outcomes were assessed.The three month GOS was scored for all patients and was used to analyse the the initial data in its light. RESULTS – A total of 200 patients were eligible for the study and were included. Of these 159 were males and 41 were females.The average age was 37.16 years.There was a relatively higher proportion of mild TBI and greater prevalence of fractures and EDH [extradural hematoma].On analyzing with three month GOS we found that 90.4 % of the patients with mild TBI had a three month GOS of 5 whereas only 31.9% of patients with moderate or severe TBI had a three month GOS of 5. CONCLUSION – The long term GOS is most representative of the extent to which the patient has been able to return to their pre TBI lives. In our study the three month GOS co related well with the initial GCS. Further prospective data can elaborate more on the effect of other clinical features and radiology on long term GOS

Download Full-text

Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow Outcome Score

Brain ◽

10.1093/brain/awp264 ◽

2009 ◽

Vol 133 (1) ◽

pp. 139-160 ◽

Cited By ~ 57

Author(s):

William L. Maxwell ◽

Mary-Anne MacKinnon ◽

Janice E. Stewart ◽

David I. Graham

Keyword(s):

Traumatic Brain Injury ◽

Cerebral Cortex ◽

Brain Injury ◽

Glasgow Outcome Score ◽

Outcome Score

Download Full-text

Comparison of Mean Glasgow Outcome Score in Patients with Traumatic Brain Injury after Magnesium Sulphate Therapy and Placebo. A Prospective Study of Shaikh Zayed Hospital Lahore

Pakistan Journal Of Neurological Surgery ◽

10.36552/pjns.v24i2.451 ◽

2020 ◽

Vol 24 (2) ◽

Author(s):

KAZIM ALI ◽

MUHAMMAD IRFAN ◽

RABIA ABBAS ◽

MUHAMMAD AFAQ SARWAR ◽

KAMRAN HUSSAIN

Keyword(s):

Traumatic Brain Injury ◽

Placebo Group ◽

Brain Injury ◽

Magnesium Sulphate ◽

Standard Treatment ◽

Therapy Group ◽

Glasgow Outcome Score ◽

Sulphate Group ◽

Outcome Score ◽

A Prospective Study

Objective: We evaluated the effectiveness of magnesium sulphate treatment for the management and outcome of TBI. Material and Methods: The prospective cases (n = 112) of TBI were included from Department of Neurosurgery, Shaikh Zayed Hospital, Lahore. Patients were split into two groups. Magnesium sulphate treatment group (n = 56) and placebo group (n = 56). Detailed history of patients was taken along with comprehensive examinations with CT scans.56 TBI patients were given standard treatment plus magnesium sulphate and remaining 56 patients received just standard treatment. Results: Mean age of the magnesium supplement therapy group was 36.83 ± 13.45 years while in the placebo group was 33.64 ± 12.88 years). Majority 28 (67.9%) were male in the magnesium sulphate group while 37 (66.1%) were in the placebo group. Mean duration passed between hospital presentation and traumatic brain injury was 4.98 ± 2.32 hours in the magnesium sulphate group while it was 5.05 ± 2.48 in the placebo group. Mean Glasgow outcome score was 3.57 ± 1.33 in the magnesium sulphate group while 2.78 ± 1.23 in the placebo group and this difference was statistically significant. Conclusion: There is significant improvement in GOS after magnesium sulphate therapy in patients with traumatic brain injury versus placebo group as noted in the results.

Download Full-text

Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial

Trials ◽

10.1186/s13063-022-06005-5 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Tao Yuan ◽

Hongyu He ◽

Yuepeng Liu ◽

Jianwei Wang ◽

Xin Kang ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Blood Glucose ◽

Brain Injury ◽

Blood Glucose Level ◽

Glucose Level ◽

Threshold Effect ◽

Glasgow Outcome Score ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Average Blood Glucose

Abstract Background Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. Methods This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. Results A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43–9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43−9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. Conclusion In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. Trial registration ClinicalTrials.gov NCT02161055. Registered on 11 June 2014.

Download Full-text

A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial

10.21203/rs.2.12680/v3 ◽

2020 ◽

Author(s):

Marthe Ford ◽

Gert J. Geurtsen ◽

Erny Groet ◽

Coen A.M. Van Bennekom ◽

Eus J.W. Van Someren

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Behavioral Therapy ◽

Cognitive Functioning ◽

Behavioral Therapy ◽

Acquired Brain Injury ◽

Cognitive Behavioral ◽

Face To Face ◽

Trial Register ◽

Insomnia Severity

Abstract Background: Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioral therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioral treatment in this population are scarce, and this applies even more for studies on online cognitive behavioral therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioral therapy for insomnia following acquired brain injury.Methods: A multicenter, prospective, randomized, open-label, blinded end point study (PROBE) will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioral therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioral therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 weeks follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation.Discussion: This study will provide insight on the efficacy of online cognitive behavioral therapy for insomnia following stroke and traumatic brain injury.Trial Register: Netherlands Trial Register, NTR7082, 12 March 2018

Download Full-text

Protocol for a Phase Two, Parallel Three-Armed Non-inferiority Randomized Controlled Trial of Acceptance and Commitment Therapy (ACT-Adjust) Comparing Face-to-Face and Video Conferencing Delivery to Individuals With Traumatic Brain Injury Experiencing Psychological Distress

Frontiers in Psychology ◽

10.3389/fpsyg.2021.652323 ◽

2021 ◽

Vol 12 ◽

Author(s):

Diane L. Whiting ◽

Grahame K. Simpson ◽

Frank P. Deane ◽

Sarah L. Chuah ◽

Michelle Maitz ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Randomized Controlled Trial ◽

Psychological Distress ◽

Brain Injury ◽

Psychological Intervention ◽

Controlled Trial ◽

Evidence Based ◽

Face To Face ◽

Randomized Controlled ◽

Severe Tbi

Background: People with traumatic brain injury (TBI) face a range of mental health challenges during the adjustment process post-injury, but access to treatment can be difficult, particularly for those who live in regional and remote regions. eHealth provides the potential to improve access to evidence-based psychological therapy for people with a severe TBI. The aim of the current study is to assess the efficacy of a psychological intervention delivered via video consulting to reduce psychological distress in people with TBI.Methods: This paper outlines the protocol for a multi-center, three-arm, parallel, non-inferiority randomized controlled trial (RCT) of an evidence-based manualized psychological intervention, ACT-Adjust. ACT-Adjust provides nine sessions for adults with a moderate to severe TBI experiencing clinical levels of psychological distress. Fifty-six participants referred from Brain Injury Rehabilitation Units across New South Wales (NSW) and the NSW icare scheme will be randomly allocated to three conditions; (1) video consulting (VC), (2) face-to-face (FtF) and, (3) a waitlist control (WL).Discussion: This is the first RCT to evaluate the efficacy of a psychological therapy (ACT-Adjust) delivered via video consulting for individuals with a moderate to severe TBI.Trial Registration:www.anzctr.org.au, Australian New Zealand Clinical Trials Registry ANZCTRN2619001602112.

Download Full-text

A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial

10.21203/rs.2.12680/v2 ◽

2020 ◽

Author(s):

Marthe Ford ◽

Gert J. Geurtsen ◽

Erny Groet ◽

Coen A.M. Van Bennekom ◽

Eus J.W. Van Someren

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Acquired Brain Injury ◽

Behavioural Therapy ◽

Face To Face ◽

Randomized Controlled ◽

Cognitive Behavioural ◽

Insomnia Severity

Abstract Background: Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioural therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioural treatment in this population are scarce, and this applies even more for studies on online cognitive behavioural therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioural therapy for insomnia following acquired brain injury.Methods: A multicenter randomized controlled trial will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioural therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioural therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 weeks follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation.Discussion: This study will provide insight on the efficacy of online cognitive behavioural therapy for insomnia following stroke and traumatic brain injury.Trial Register: Netherlands Trial Register, NTR7082, 12 March 2018

Download Full-text