Incremental Validity of Neuropsychological Evaluations to Computed Tomography in Predicting Long-Term Outcomes after Traumatic Brain Injury

Abstract

This study evaluated the incremental utility of neuropsychological tests to computed tomography (CT) in predicting long-term outcomes of adults with moderate to severe traumatic brain injury (TBI). Participants were 288 adults with mild complicated, moderate, and severe TBI. Longitudinal data were evaluated during inpatient status in an urban rehabilitation hospital with a TBI Model System, as well as 1 and 2 years post injury. Predictors including demographic characteristics, injury severity, CT characteristics, and neuropsychological evaluations were regressed to outcomes of disability, life satisfaction, and employment at 1 and 2 years post injury. Prediction of life satisfaction was not improved with the use of CT characteristics or neuropsychological tests, but prediction of return to work was improved by these variables at 2 years post injury. Neuropsychological evaluations uniquely contributed to outcome predictions of functional disability, even after considering demographic and injury severity characteristics, including information from CT. In contrast, CT characteristics were not predictive of long-term functional disability at 1 or 2 years post TBI. Taken together, the findings indicate that neuropsychological tests add unique predictive information for long-term functional outcomes after TBI.

Keywords:

• Traumatic brain injury
• Neuropsychological testing
• Cognitive functioning
• Computed tomography
• Disability
• Outcomes
• Rehabilitation.

Acknowledgement

This project was supported by Wayne State University Graduate School, National Institute of General Medicine - Initiative for Maximizing Student Development (GM058905-11), and the National Institute on Disability & Rehabilitation Research – Traumatic Brain Injury Model Systems Project (H133A080044). We would like to acknowledge Robert Kotasek for his work managing the dataset.