Improved sensitivity of the rapid screen of mild traumatic brain injury

• Published in: Journal of clinical and experimental neuropsychology 2010-01, Vol.32 (1), p.28-37
• Main Authors: De Monte, Veronica Eileen, Geffen, Gina Malke, May, Christopher Randall, McFarland, Ken
• Format: Article
• Language: English
• Subjects: Acute Disease; Acute effects; Adolescent; Adult; Adult and adolescent clinical studies; Analysis of Variance; Biological and medical sciences; Brain Injuries - complications; Brain Injuries - diagnosis; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Female; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Logistic Models; Male; Mass Screening - methods; Medical sciences; Middle Aged; Mild traumatic brain injury; Neuropsychological Tests; Neuropsychology; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Reproducibility of Results; ROC Curve; Sensitivity; Sensitivity and Specificity; Severity; Sex Factors; Techniques and methods; Time Factors; Trauma Severity Indices; Traumas. Diseases due to physical agents; Verbal Learning; Young Adult
• ISSN: 1380-3395; 1744-411X
• DOI: 10.1080/13803390902806519

This study aimed to investigate the acute effects of mild traumatic brain injury (mTBI) in an emergency department sample. A total of 246 (186 male, 60 female) cases of mTBI and 102 (65 male and 37 female) cases of orthopedic injuries were tested within 24 hours of injury. Mild TBI patients performed more poorly on all subtests of the Rapid Screen of Concussion (RSC) and completed fewer symbols on Digit Symbol than did orthopedic controls. RSC scores predicted group membership better than chance, and Digit Symbol scores contributed significantly to predicting group membership over and above the contribution of the RSC, resulting in 70.4% sensitivity and 74% specificity for the extended protocol. The results of this study indicate that learning and memory, orientation, and speed of information processing are impaired immediately following mTBI. Furthermore, a brief battery of tests that include word recall, orientation, and the Digit Symbol Substitution Test could assess the severity of dysfunction following mTBI, and assist in clinical decision making regarding discharge, return to routine activities, and management of the effects of injury.