Analysis of influencing factors of cognitive impairment after moderate traumatic brain injury

Abstract

Objective To analyze the influencing factors of cognitive impairment after moderate traumatic brain injury and to develop prognostic models for cognitive impairment after moderate traumatic brain injury. Methods A prospective study was performed on 104 patients with moderate traumatic brain injury at Department of Neurosurgery, the Third Xiangya Hospital, Central South University from November 2016 to February 2018. The cognitive function at 3 months after injury was assessed using the Montreal cognitive assessment (MoCA) score. The impact of various lesions on cognitive function was analyzed using univariate and multivariate logistic regression. Prognostic models was established based on logistic regression analysis results. The validation sampling was used to compute the accuracy, sensitivity and specificity of the prognostic models. Results Logistic regression analysis revealed that age (OR=1.118, 95%CI: 1.000-1.250, P=0.049), education (OR=0.202, 95%CI: 0.041-0.988, P=0.045), Glasgow coma scale (GCS) score (OR=2.582, 95%CI: 1.242-5.369, P=0.011) and injury cause (OR=0.429, 95%CI: 0.201-0.915, P=0.029) were independent risk factors of cognitive impairment after moderate traumatic brain injury. The prognostic model based on the risk factors of admission had favorable performance (P>0.05 for partial chi square test, 0.902 for area under curve). The accuracy of the prognostic model was 88.6%. The sensitivity and specificity were 55.6% and 100.0% respectively. Conclusions Age, education, GCS score and injury cause are influencing factors of cognitive impairment after moderate traumatic brain injury, based on which the established model could be used to timely and accurately predict the prognosis of cognitive impairment after moderate traumatic brain injury. Key words: Craniocerebral trauma; Cognitive disorder; Logistic models; Forecasting models