Early conversational discourse abilities following traumatic brain injury: An acute predictive study

Abstract

Primary objective: To date, little information is available regarding communication and conversational discourse proficiency post-traumatic brain injury (TBI) in the acute care phase. The main goal of this study was to examine how conversational discourse impairment following TBI predicts early outcome. Factors which influence conversational discourse performance were also explored.

Methods: The conversational discourse checklist of the Protocole Montréal d’évaluation de la communication (D-MEC) was administered in an acute tertiary care trauma centre to 195 adults within 3 weeks post-TBI. Outcome was measured with the Disability Rating Scale (DRS), the extended Glasgow Outcome Scale (GOS-E) and included discharge destinations from acute care.

Main outcomes and results: Linear regression results showed that the D-MEC total score, age and initial GCS score accounted for 50% of the variation of the DRS scores. The DRS score was lower, signifying better outcome, when the total D-MEC score was higher, the subject was younger and when the initial GCS score was higher. Moreover, D-MEC performance significantly predicted the moderate and severe disability categories of the GOS-E and the probability of requiring rehabilitation (p < 0.05).

Conclusion: These results provide additional information to guide healthcare professionals in predicting overall outcome acutely post-TBI.

• Acute care
• conversational discourse
• outcome
• Protocole Montréal d’évaluation de la communication
• traumatic brain injury

Acknowledgements

We thank the Research Institute of the McGill University Health Center for their support.