Cognitive and psychosocial outcome in survivors of severe XXXX : correlations with cerebral perfusion pressure, frontal lobe damage and somatosensory evoked potentials.

@entity1 @entity131 @entity73 @entity542 @entity772
OBJECTIVE: To correlate neuropsychological outcome in @entity1 after severe traumatic @entity542 , with neurophysiological and neuroradiological data collected during the intensive care unit (ICU) period of care. METHODS: @entity1 admitted to Waikato Hospital ICU with severe traumatic @entity542 were studied. Respiratory difficulty at the accident site, admission Glasgow @entity772 Score (GCS), anatomic traumatic brain disruption as quantified by a cerebral computed tomography score, prolongation of the central conduction time (CCT) of somatosensory evoked potentials and the percentage time that the cerebral perfusion pressure was less than 70 mmHg (%CPP < 70) were measured. Neuropsychological outcome was assessed, in terms of cognitive and behavioural function, by the Controlled Oral Word Association (COWA) test (performed by the @entity1 ) and @entity542 Behaviour rating scale (HIBS, performed by their caregiver) respectively, one year following injury. RESULTS: Sixty-eight @entity1 with a median post-resuscitation GCS of 6 were able to complete the neuropsychological follow up. Most @entity1 had significantly impaired cognitive and behavioural function (mean COWA = 32 and HIBS = 9.7). Cognitive function did not correlate significantly with behavioural function (COWA vs HIBS, r = -0.14, p = 0.27). There were no significant correlations between either GCS (r = 0.15, p = 0.28) or estimates of respiratory difficulty at the accident scene and neuropsychological outcome. Poor cognitive outcome (COWA) was correlated with %CPP < 70 (r =-0.41, p = 0.005) and prolonged CCT (r = 0.26, p = 0.03). There was an insignificant correlation between the CT score and cognitive outcome (frontal lobe score vs COWA, r = -0.12, p = 0.33). However, the group of @entity1 with the most severe @entity131 tended to have a worse behavioural outcome as assessed by the HIBS. CONCLUSIONS: Behavioural outcome as quantified by the caregiver (HIBS) does not correlate well with the degree of @entity73 as measured directly from the @entity1 (COWA). Severely head injured @entity1 with poor neurophysiological indicators (%CPP < 70 or prolonged CCT) have a poor neuropsychological outcome. However, anatomical disruption of the brain as estimated by the frontal lobe CT score correlated poorly with outcome.
