TBI Intro: Outcome Measures Flashcards
glasgow coma scale
classifies acute injury as mild, mod, severe TBI
ranchos los amigos levels of cognitive function (LOCF)
delineates 8-10 cognitive and behavioral levels
rappaports disability rating scale (DRS)
classifies levels of disability using a wide range of functional behaviors
glasgow outcome scale
expands original GCS scale
includes major disability categories for outcome assessment
galveston orientation and amnesia test (GOAT) and orientation log (O-Log)
measure post traumatic amnesia
coma recovery scale (CRS-R)
assists with differential diagnosis, prognostic assessment, treatment planning for disorder of consciousness
disorder of consciousness scale (DOCS)
measures arousal and neurobehavioral behavior in pt’s with disorders of consciousness
glasgow coma scale components
pupillary response
motor activity
ability to verbalize
glasgow coma scale score ranges
3-8 severe
9-12 moderate
13-15 mild
if u get a 3 on the GCS on initial presentation what does that result in
65-100% tbi mortality rate
mild tbi: GCS score: LOC: consciousness: post-traumatic amnesia: imaging:
- 13-15
- 0-30 mins
- brief (<24hrs) alteration of consciouness
- <1 day
- normal
moderate tbi: GCS score: LOC: consciousness: post-traumatic amnesia: imaging:
- 9-12
- > 30 mins but <24 hours
- alteration of consciousness >24 hrs
- > 1 but <7 days
- normal or abnormal
severe tbi: GCS score: LOC: consciousness: post-traumatic amnesia: imaging:
- 3-8
- > 24 hours
- alteration of consciousness >24 hrs
- > 7 days
- normal or abnormal
disability rating scale (DRS)
- measures aspects of impairment, function and participation
- track progress for pt’s in a coma through community integration phase
areas on the DRS
- consciousness (eye opening, verbal, motor)
- cognitive ability (feeding, toileting, grooming)
- independence/dependence level of function
- employability
high scores represent what on the DRS
high level of disability
scores from the DRS can predict what
predict return to work potential (88% accurate)
negative prognostic indicators for TBI
morbidity and fxn
- older age
- female
- GCS score
- length of PTA
- acquired injury
- lower ed level
- delayed or inability to use neurostimulants
- presence of pre-injury psychological issues or substance abuse
- GOS: level 1-3
- initial GCS: 3-8
severe prognostic factors
morbidity and mortality
- older age
- absence of light reflex
- presence of extensive subarachnoid hemorrhage
- sustained elevated intracranial pressure
- midline shift
what residual impairment are present that you need to consider before community re-integration
- decreased social inhibitions
- impaired motor control
- impaired attention, memory, sequencing & high level problem solving
- perseveration or word finding issues
- impaired speech
- impaired writing or calculating ability
- vision impairments
- topographic routing issues
- balance issues, incoordination
