Archives of physical medicine and rehabilitation · 2026
Individual Prognostication of Emergence From Posttraumatic Amnesia: A Nationwide Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Evald Lars, Pedersen Carsten Bøcker, Norup Anne, Zoetmulder Marielle
Аннотация
OBJECTIVE: To predict individual emergence from posttraumatic amnesia (PTA) in patients with moderate to severe traumatic brain injury (TBI).
DESIGN: Prospective nationwide cohort study based on data from a national registry: Danish Head Trauma Database.
SETTING: Two highly specialized neurorehabilitation hospitals in Denmark.
PARTICIPANTS: Patients with TBI (N=1606) admitted between 2004 and 2020 were included in the study.
INTERVENTIONS: No treatment effects were tested in the study, but participants were admitted for highly specialized neurorehabilitation.
MAIN OUTCOME MEASURES: Duration of PTA, defined as the number of days from TBI onset until regaining anterograde memory function, is a proxy for the resolution of the confusional state. Using competing risk survival analyses, we estimated absolute risks (probabilities) of emerging from PTA according to the included covariates of interest: sex, age, severity of TBI, and time since injury.
RESULTS: A total of 955 patients with TBI (mean age, 45.2; [SD, 17.8], 21% women) were included in the study, of which 658 emerged from PTA within 1 year. In the fully adjusted model, male sex, older age, and greater TBI severity were associated with a lower probability of emerging from PTA. Among patients with severe TBI, 99 of 100 in the youngest age group will emerge from PTA within 1 year, compared with 72 of 100 in the oldest age group. Among patients with very severe TBI, the corresponding estimated probabilities are 62 and 24 of 100 within 1 year, respectively.
CONCLUSIONS: The prognostic model offers clinicians an evidence-based tool to individually predict the probability of emergence from PTA in patients with TBI, incorporating key prognostic factors while accounting for competing risks such as mortality and nonemergence.
DESIGN: Prospective nationwide cohort study based on data from a national registry: Danish Head Trauma Database.
SETTING: Two highly specialized neurorehabilitation hospitals in Denmark.
PARTICIPANTS: Patients with TBI (N=1606) admitted between 2004 and 2020 were included in the study.
INTERVENTIONS: No treatment effects were tested in the study, but participants were admitted for highly specialized neurorehabilitation.
MAIN OUTCOME MEASURES: Duration of PTA, defined as the number of days from TBI onset until regaining anterograde memory function, is a proxy for the resolution of the confusional state. Using competing risk survival analyses, we estimated absolute risks (probabilities) of emerging from PTA according to the included covariates of interest: sex, age, severity of TBI, and time since injury.
RESULTS: A total of 955 patients with TBI (mean age, 45.2; [SD, 17.8], 21% women) were included in the study, of which 658 emerged from PTA within 1 year. In the fully adjusted model, male sex, older age, and greater TBI severity were associated with a lower probability of emerging from PTA. Among patients with severe TBI, 99 of 100 in the youngest age group will emerge from PTA within 1 year, compared with 72 of 100 in the oldest age group. Among patients with very severe TBI, the corresponding estimated probabilities are 62 and 24 of 100 within 1 year, respectively.
CONCLUSIONS: The prognostic model offers clinicians an evidence-based tool to individually predict the probability of emergence from PTA in patients with TBI, incorporating key prognostic factors while accounting for competing risks such as mortality and nonemergence.