Abstract
Sherer M, Yablon SA, Nakase-Richardson R. Patterns of recovery of posttraumatic confusional state in neurorehabilitation admissions after traumatic brain injury. Objective To provide preliminary descriptions of patterns of resolution of symptoms of acute confusion after traumatic brain injury (TBI). Design Prospective, descriptive, cohort study. Setting Inpatient neurorehabilitation unit. Participants Patients (N=107) meeting criteria for posttraumatic confusional state at admission to inpatient rehabilitation. Interventions Not applicable. Main Outcome Measure Patterns of resolution of posttraumatic confusional state symptoms over the first 3 confusion assessment protocol evaluations for patients with mild, moderate, and severe confusion. Results Posttraumatic confusional state symptoms resolving earliest were psychotic-type symptoms, decreased daytime arousal, and nighttime sleep disturbance. Fluctuation and cognitive impairment were the 2 most persistent symptoms. Seventy-three percent of patients showed improvement of 1 or more symptoms from the first to third evaluation. Confusion severity groups did not significantly differ on indices of injury severity (Glasgow Coma Scale score, time to follow commands) but did differ on functional status at discharge from inpatient rehabilitation. Conclusions While posttraumatic confusional state is a heterogeneous disorder, there is a predictable pattern of symptom resolution. Differences in patients' confusion severity and patterns of symptoms may relate to differing underlying neural injury.
Published Version
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