Research Reports - Behavioral problems in the first year after traumatic brain injury

 Clin Rehabil. 2016 Jun 8. pii: 0269215516652184. [Epub ahead of print]

Nygren DeBoussard C(1), Lannsjö M(2), Stenberg M(3), Stålnacke BM(3), Godbolt

OBJECTIVE: To investigate the occurrence of behavioural problems in patients with
severe traumatic brain injury during the first year after injury and potential
associations with outcome. An additional post hoc objective was to analyse the
frequency of behaviours with need for intervention from staff.
DESIGN AND SETTING: In a prospective population based cohort study 114 patients
with severe traumatic brain injury were assessed at three weeks, three months and
one year after injury.
MAIN MEASURES: Assessments included clinical examination and standardised
instruments. Agitation was assessed with the Agitated Behaviour Scale, the course
of recovery by the Rancho Los Amigo Scale and outcome by Glasgow Outcome Scale
RESULTS: Agitation were most common at 3 weeks post injury and 28% (n=68) of the
patients showed at least one agitated behaviour requiring intervention from
staff. Presence of significant agitation at 3 weeks after injury was not
associated with poor outcome. At 3 months agitation was present in 11% (n=90) and
apathy in 26 out of 81 assessed patients. At 3 months agitation and apathy were
associated with poor outcome at one year.
CONCLUSIONS: Most agitated behaviours in the early phase are transient and are
not associated with poor outcome. Agitation and apathy are uncommon at three
months but when present are associated with poor outcome at one year after
injury. In the early phase after a severe traumatic brain injury agitated
behaviour in need of interventions from staff occur in a substantial proportion
of patients. 

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