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Godbolt, Alison K.
Alternative names
Publications (6 of 6) Show all publications
Nygren DeBoussard, C., Lannsjö, M., Stenberg, M., Stalnacke, B.-M. & Godbolt, A. K. (2017). Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study. Clinical Rehabilitation, 31(4), 555-566
Open this publication in new window or tab >>Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study
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2017 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 4, p. 555-566Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the occurrence of behavioural problems in patients with severe traumatic brain injury during the first year after injury and potential associations with outcome. An additional post hoc objective was to analyse the frequency of behaviours with need for intervention from staff.

Design and setting: In a prospective population based cohort study 114 patients with severe traumatic brain injury were assessed at three weeks, three months and one year after injury.

Main measures: Assessments included clinical examination and standardised instruments. Agitation was assessed with the Agitated Behaviour Scale, the course of recovery by the Rancho Los Amigo Scale and outcome by Glasgow Outcome Scale Extended.

Results: Agitation were most common at 3 weeks post injury and 28% (n=68) of the patients showed at least one agitated behaviour requiring intervention from staff. Presence of significant agitation at 3 weeks after injury was not associated with poor outcome. At 3 months agitation was present in 11% (n=90) and apathy in 26 out of 81 assessed patients. At 3 months agitation and apathy were associated with poor outcome at one year.

Conclusions: Most agitated behaviours in the early phase are transient and are not associated with poor outcome. Agitation and apathy are uncommon at three months but when present are associated with poor outcome at one year after injury. In the early phase after a severe traumatic brain injury agitated behaviour in need of interventions from staff occur in a substantial proportion of patients.

Keywords
Severe traumatic brain injury, prognosis, agitation, behaviour, outcome, assessment
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-322835 (URN)10.1177/0269215516652184 (DOI)000400092500013 ()
Funder
AFA Insurance, 060833AFA Insurance, 130095
Available from: 2017-06-08 Created: 2017-06-08 Last updated: 2017-06-08Bibliographically approved
Godbolt, A. K., DeBoussard, C. N., Stenberg, M., Lindgren, M., Ulfarsson, T. & Borg, J. (2013). Disorders of consciousness after severe traumatic brain injury: a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways. Journal of Rehabilitation Medicine, 45(8), 741-748
Open this publication in new window or tab >>Disorders of consciousness after severe traumatic brain injury: a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways
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2013 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 8, p. 741-748Article in journal (Refereed) Published
Abstract [en]

Background: Very severe traumatic brain injury may cause disorders of consciousness in the form of coma, unresponsive wakefulness syndrome (also known as vegetative state) or minimally conscious state. Previous studies of outcome for these patients largely pre-date the 2002 definition of minimally conscious state. Objectives: To establish the numbers of patients with disorder of consciousness at 3 weeks, 3 months and 1 year after severe traumatic brain injury, and to relate conscious state 3 weeks after injury to outcomes at 1 year. Design: Multi-centre, prospective, observational study of severe traumatic brain injury. Inclusion criteria: lowest (non-sedated) Glasgow Coma Scale 3-8 during the first 24 h; requirement for neurosurgical intensive care; age 18-65 years; alive 3 weeks after injury. Diagnosis of coma, unresponsive wakefulness syndrome, minimally conscious state or emerged from minimally conscious state was based on clinical and Coma Recovery Scale Revised assessments 3 weeks, 3 months and 1 year after injury. One-year outcome was measured with Glasgow Outcome Scale Extended (GOSE). Results: A total of 103 patients was included in the study. Of these, 81% were followed up to 1 year (76% alive, 5% dead). Three weeks after injury 36 were in coma, unresponsive wakefulness syndrome or minimally conscious state and 11 were anaesthetized. Numbers of patients who had emerged from minimally conscious state 1 year after injury, according to status at 3 weeks were: coma (0/6), unresponsive wakefulness syndrome (9/17), minimally conscious state (13/13), anaesthetized (9/11). Outcome at 1 year was good (GOSE>4) for half of patients in minimally conscious state or anaesthetized at 3 weeks, but for none of the patients in coma or unresponsive wakefulness syndrome. These differences in outcome were not revealed by prognostic predictions based on acute data. Conclusion: Patients in minimally conscious state or anaesthetized 3 weeks after injury have a better prognosis than patients in coma or unresponsive wakefulness syndrome, which could not be explained by acute prognostic models.

Keywords
traumatic brain injury, prognosis, vegetative state, minimally conscious state, outcome, care pathways
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-211908 (URN)10.2340/16501977-1167 (DOI)000326357500008 ()
Available from: 2013-12-03 Created: 2013-12-03 Last updated: 2017-12-06Bibliographically approved
Godbolt, A., Nygren-DeBoussard, C., Stenberg, M., Ulfarsson, T., Lindgren, M., Karlsdottir, G. & Borg, J. (2012). Cognitive recovery in the first 3 months after severe traumatic brain injury: preliminary data from "PROBRAIN'' study. Paper presented at the International Brain Injury Association's Ninth World Congress on Brain Injury. March 21-25 in Edinburgh, Scotland.. Brain Injury, 26(4-5), 639-639
Open this publication in new window or tab >>Cognitive recovery in the first 3 months after severe traumatic brain injury: preliminary data from "PROBRAIN'' study
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2012 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 4-5, p. 639-639Article in journal, Meeting abstract (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-175978 (URN)10.3109/02699052.2012.660091 (DOI)000304104600591 ()
Conference
the International Brain Injury Association's Ninth World Congress on Brain Injury. March 21-25 in Edinburgh, Scotland.
Available from: 2012-06-15 Created: 2012-06-14 Last updated: 2017-12-07Bibliographically approved
Godbolt, A., Stenson, S., Winberg, M., Flink, R., Axelson, H. & Tengvar, C. (2012). Diagnosis of Disorders of Consciousness: Evoked Potentials and Behavioural Assessment in clinical practice. Paper presented at The International Brain Injury Association's Ninth World Congress on Brain Injury. March 21-25 in Edinburgh, Scotland.. Brain Injury, 26(4-5), 513-514
Open this publication in new window or tab >>Diagnosis of Disorders of Consciousness: Evoked Potentials and Behavioural Assessment in clinical practice
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2012 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 4-5, p. 513-514Article in journal, Meeting abstract (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-175976 (URN)10.3109/02699052.2012.660091 (DOI)000304104600372 ()
Conference
The International Brain Injury Association's Ninth World Congress on Brain Injury. March 21-25 in Edinburgh, Scotland.
Available from: 2012-06-15 Created: 2012-06-14 Last updated: 2017-12-07Bibliographically approved
Godbolt, A. K., Stenson, S., Winberg, M. & Tengvar, C. (2012). Disorders of consciousness: Preliminary data supports added value of extended behavioural assessment. Brain Injury, 26(2), 188-193
Open this publication in new window or tab >>Disorders of consciousness: Preliminary data supports added value of extended behavioural assessment
2012 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 2, p. 188-193Article in journal (Refereed) Published
Abstract [en]

Background: The use of validated behavioural assessment scales in assessment of patients with Disorders of Consciousness (DOC) is well established. However, there is little evidence to guide decisions on total time spent in behavioural assessment.

Objective: To assess whether brief behavioural assessment was as effective as extended behavioural assessment in detecting non-vegetative behaviours.

Methods: Consecutive patients with suspected DOC were assessed with two standardized instruments: Coma Recovery Scale Revised (CRS-R) and Sensory Modality Assessment and Rehabilitation Technique (SMART). Assessors were blinded to results from the other scale at the point of assessment. Two administrations of CRS-R together took 50-60 minutes ('brief' assessment). One complete SMART assessment took 600 minutes ('extended' assessment). Patients were classified as being in a vegetative state (VS) or minimally conscious state (MCS)/emerged from minimally conscious state (EMCS), following brief and extended assessment.

Results: Ten patients were assessed. Brief and extended assessment yielded the same diagnostic category (VS or MCS) for six patients and different categories for four, with extended assessment detecting higher level behaviours.

Conclusions: Brief behavioural assessment was not as effective as extended assessment in detecting non-vegetative behaviours. Total time spent in behavioural assessment is likely important. Further studies and clearer clinical guidance are needed.

Keywords
Vegetative state, minimally conscious state, disorders of consciousness, behavioural assessment, brain injury
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-171438 (URN)10.3109/02699052.2011.648708 (DOI)000300658200008 ()
Available from: 2012-03-19 Created: 2012-03-19 Last updated: 2017-12-07Bibliographically approved
Nygren-DeBoussard, C., Godbolt, A., Stenberg, M., Ulfarsson, T., Lindgren, M., Karlsdottir, G. & Borg, J. (2012). Trajectories of Recovery and Outcome after Severe Traumatic Brain Injury: Design and baseline data from the "PROBRAIN" study. Paper presented at The International Brain Injury Association's Ninth World Congress on Brain Injury. March 21-25 in Edinburgh, Scotland.. Brain Injury, 26(4-5), 560-561
Open this publication in new window or tab >>Trajectories of Recovery and Outcome after Severe Traumatic Brain Injury: Design and baseline data from the "PROBRAIN" study
Show others...
2012 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 4-5, p. 560-561Article in journal, Meeting abstract (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-175977 (URN)10.3109/02699052.2012.660091 (DOI)000304104600452 ()
Conference
The International Brain Injury Association's Ninth World Congress on Brain Injury. March 21-25 in Edinburgh, Scotland.
Available from: 2012-06-15 Created: 2012-06-14 Last updated: 2017-12-07Bibliographically approved
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