Models for predicting traumatic brain injury outcomes in the older patients, accounting for cognitive status

Introduction. Predicting the outcomes of traumatic brain injury (TBI) depending on the degree of cognitive impairment is important for optimizing diagnostic and therapeutic care, but cognitive impairments are rarely used in predictive models.

Aim. To develop models for predicting the outcomes of mild and moderate TBI in elderly patients, taking into account cognitive status.

Material and methods. A total of 125 patients aged 60–74 years with mild and moderate TBI were examined on days 8–9 and 20–21, respectively. TBI outcomes were classified into 3 groups: 1 – patients’ ability to perform motor and sensory actions, 2 – mood and interpersonal interaction, 3 – social contacts and work. Cognitive impairments were detected using the Mini-Mental State Examination (MMSE). The Statistica 17.0 program and regression analysis were used to develop predictive models of the above-mentioned TBI outcomes.

Results. Weak inverse correlations between mild TBI severity and TBI outcomes were established. However, the association of moderate TBI severity with outcomes was higher than for mild TBI, especially for participation in social contacts and work (r = -0.452; p < 0.01) and for mood and interpersonal interaction (r = -0.406; p < 0.01). In all cases, the outcomes of TBI with cognitive impairments had a moderate positive correlation, with correlation coefficients from 0.339 to 0.372 (p < 0.01). To predict the ability of patients to perform motor and sensory actions (y₄), taking into account the score of cognitive impairment (x₄), an adjusted model y₄ = 7,389–1,724x4 was created. To predict mood and interpersonal interaction, an adjusted model y₅ = 8,241–1,406x5; to predict patient participation in social contacts and work, an adjusted model y₆ = 7,895– 1,469x6, where x₅ and x₆ are the scores of cognitive impairments on the MMSE scale.

Conclusion. The results show the negative impact of cognitive impairment on the outcomes of TBI, for the prediction of which prognostic models have been developed.

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