COGNITIVE PROFILE OF VICTIMS IN CRITICAL CONDITIONS ASSOCIATED WITH COMBAT AND NON-COMBAT TRAUMA
About the author:
Krishtafor A. A., Yovenko I. A., Krishtafor D. A., Oleniuk D. V.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
The purpose of the study: to determine the peculiarities of cognitive impairment in critical conditions associated with combat and non-combat trauma. 56 injured were examined: 19 with combat trauma and 37 with non-combat trauma. The severity of the injury was assessed according to the ISS, the severity at admission on the scales of SAPS II and EmTraS. The state of cognitive functions prior to trauma was evaluated retrospectively using the CFQ. Cognitive functions after the injury were assessed on the second day, before transfer from the intensive care unit and before discharge from the hospital. MoCA and MMSE scales were used to assess cognitive functions. Results: Patients of both groups were comparable in age and severity of the trauma. In patients with non-combat trauma according to the MoCA scale, the decline was most affected by attention and speech, and in patients with combat was reduced attention, visual-constructive skills and delayed reproduction. According to the MMSE scale in patients with non-combat trauma, the decline was noted mainly in the attention and counting subscales, reproduction and drawing. In patients with combat trauma the picture of cognitive decline was similar. In patients with non-combat trauma, the condition of impaired cognitive functions during treatment in the intensive care unit did not change, but by the time of discharge, a partial restoration of visual-constructive/performing skills and increased attention, combined with a slight decrease in the subscale “abstraction” was noted. In the group with combat trauma, the level of cognitive functions remained unchanged throughout the period of treatment in the hospital with some improvement in the subscales “abstraction” and “orientation”. According to the MMSE scale in patients with noncombat trauma, the dynamics of the state of cognitive functions was generally consistent with the data obtained with the MoCA scale. In patients with combat trauma, the tendency to recovery was noted only at the stage of transfer from the intensive care unit and concerned only the subscale “reproduction”, “speech” and “writing”. At the stage of discharge from the hospital, most cognitive functions remained at the level of the previous stage, and such as “repetition” and “drawing” even decreased. Conclusions: The use of the MoCA and MMSE scales is an important element of the monitoring of CNS condition in intensive care for victims with combat and non-combat trauma; victims with combat trauma have some differences in the cognitive profile from patients with non-combat trauma.
Tags:
cognitive impairment, trauma, MoCA, MMSE
Bibliography:
- Krishtafor A. Kognitivnye narushenija, obuslovlennye kriticheskimi sostojanijami, kak projavlenie cerebralnoj nedostatochnosti. Med. neotl.sost. 2015;2(65):32-5. [in Russian].
- Bakhadova EM. Otdalennye posledstvija minno-vzryvnoj travmy na nejrofziologicheskoe sostojanie golovnogo mozga. Fundam. issled. 2014;2:28-33. [in Russian].
- Waldemar G, Dubois B, Emre M, Georges J, McKeith IG, Rossor M, et al. Recommendatons for the diagnosis and management of Alzheimer’s disease and other disorders associated with dementa: EFNS guideline. Eur. J. Neurol. 2007;14:1-26.
- Usenko LV, Rizk ShE, Krishtafor AA. Posleoperacionnaja kognitvyvnaja disfunkcija kak anesteziologicheskaja problema i put eje reshenija. Bil, znebol. i intens. ter. 2008;4:14-20. [in Russian].
- Likhvantsev VV, Kulikov VA, Bolshedvorov RV, Kichin VV, Fedorov SA. Vozmozhnye prichiny i put proflaktki korotkih posleoperacionnyh psihiceskih narushenij pri regionarnoj i obshchej anestezii. Anest. i reanim. 2008;6:71-4. [in Russian].
- Poinchuk IS. Optmizacija vidnovlennja psyhofziologichnyh funkcij pislja riznyh vydiv zagalnoji anesteziji v umovah stacionaru odnogo dnja. Med. neotl. staniv. 2009;6(22). Dostupno: htp://www.mif-ua.com/archive/artcle/11218 [in Ukrainian].
- Kozhemiaka NV, Nalapko YuI. Posleoperatsionnaja kognitvnaja disfunkcija: novye vozmozhnost proflaktki i lechenija. Mezhdunar. nevrol. zh. 2010;2:38-42. [in Russian].
- Volkov AO, Kligunenko EN, Vetoshka IA. Kak ocenit’ kognitvnye funkcii pered kesarevym secheniem? 2014;3. Dostupno: htps://scienceeducaton.ru/ru/artcle/view?id=13474 [in Russian].
Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 141-145 pages, index UDK 616.89-008.44