Traumatic brain injury and post-traumatic amnesia: a retrospective review of discharge outcomes

Brain Inj. 2017;31(13-14):1840-1845. doi: 10.1080/02699052.2017.1346288. Epub 2017 Aug 22.

Abstract

Primary objective: To investigate if patients with traumatic brain injury, who are discharged to the community before emergence from post-traumatic amnesia (PTA), experience more adverse outcomes than those discharged after emergence from PTA.

Research design: A retrospective review of previously collected data and medical records.

Methods and procedures: Occurrences of adverse events including hospital readmissions, disengagement from follow-up services, non-compliance with discharge precautions, support system breakdown or undue carer strain at the post-discharge clinic review were recorded. The Glasgow Outcome Scale - Extended (GOS-E) and Supervision Rating Scale (SRS) were completed, retrospectively. Twenty-seven patients discharged to the community, prior to emergence from PTA, were compared to 20 patients discharged within seven days of emergence from PTA.

Main outcomes and results: Patients discharged prior to emergence from PTA did not experience an increase in adverse outcomes and showed a higher level of engagement in follow-up services (p = 0.015). There was no difference between groups in the improvements from discharge to clinic review on the GOS-E (p = 0.113) and SRS (p = 0.165).

Conclusions: Patients can be discharged prior to emergence from PTA, if all other discharge criteria have been met, without an increase in adverse outcomes.

Keywords: Brain injury; discharge outcomes; post-traumatic amnesia.

MeSH terms

  • Adult
  • Amnesia / etiology*
  • Brain Injuries, Traumatic / complications*
  • Brain Injuries, Traumatic / rehabilitation
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Patient Discharge*
  • Residence Characteristics
  • Retrospective Studies
  • Statistics, Nonparametric
  • Young Adult