Acute confusion following traumatic brain injury

Abstract

Primary objective: To determine the incidence, duration and symptoms associated with acute confusion/delirium among traumatic brain injury (TBI) neuro-rehabilitation admissions.

Research design: Prospective evaluation of neurobehavioural impairments following TBI among inpatient neurorehabilitation admissions.

Methods and procedures: Eighty-five consecutive TBI model system patients were evaluated using measures of orientation, cognition, motor restlessness and delirium.

Main outcomes and results: Fifty-nine individuals met Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition Delirium Diagnostic Criteria (DDC) on initial evaluation and 42 of these resolved delirium during inpatient rehabilitation. Multivariable logistic regression analyses revealed significant unique associations of the Galveston Orientation and Amnesia Test (GOAT), Delirium Rating Scale, Cognitive Test for Delirium and time elapsed since injury with DDC status.

Conclusions: Findings indicate that delirium is common among neuro-rehabilitation admissions with TBI. Use of a single measure (e.g. GOAT) will result in poor characterization of the multi-faceted symptom complex shown by patients with post-traumatic confusion.