Cognitive assessment of patients without brain injury at ICU discharge, comparison with mild and moderate traumatic brain injury patients. Preliminary results

Introduction/Background Significant cognitive impairment after ICU stays in up to 40% of patients without any initial brain damage has been reported. This is a part of the Post Intensive Care Syndrome, alongside motor and psychiatric dysfunctions. In these studies, cognitive evaluation scores are found similar to scores for patients with moderate traumatic brain injury. However, the precise nature and magnitude of the cognitive disorders are not well described. We decided to deepen analysis of cognitive disorders in non-brain injury patients at ICU discharge (No-BI) and develop a comparison with mild and moderate traumatic brain injury patients (TBI). Material and method After ICU stay (≥48 hours), we administered outcome measures (GOSE, DRS) and neuropsychological tests to assess global cognitive functioning (MOCA), working memory (digit span), spatial neglect (line bisection), selective attention and speed processing (bells cancellation) to No-BI and TBI patients. Patients with history of neurologic or psychiatric troubles were not included. For each patient, we noted age, gender, initial Glasgow Coma Score (GCS), type of disease, and intubation and sedation periods in ICU. Results We tested 16 No-BI and 32 TBI. GCS and intubation period were significantly lower for TBI compared to No-BI (respectively P  = 0.04 and P  = 0.01). The median GOSE for both groups was 5 (lower moderate disability). Neuropsychological measures showed no significant difference between No-BI and TBI patients. Only MOCA (No-BI: 21 ± 5 and TBI: 21 ± 5) and digit span (No-BI: 7 ± 2 and TBI: 7 ± 2) are significantly lower than normality ( P Fig. 1 ). Conclusion We found no neuropsychological difference between No-BI and TBI patients, confirming the hypothesis that these two populations have comparable global cognitive functioning and working memory impairment at ICU discharge. We need more patients to improve these results. A new evaluation at 12 months will allow discussing a possible recovery.