Peculiarities of cognitive impairment in patients wounded in action
Background. Investigation of the effect of combat stress on the severity of cognitive impairment in the early period after a severe injury has an important practical meaning in terms of improving the quality of life of the wounded patients and faster and full adaptation in the posttraumatic period. The aim of this study was to determine differences in cognitive dysfunction in the posttraumatic period between combat and non-combat trauma patients. Materials and methods. Injury severity was assessed by RTS, ISS and TRISS scales. Stress response was estimated by IES-R scale. Somatic reaction to injury and stress was evaluated using the Kerdo and glucose-leukocyte indexes. Cognitive functions were assessed by FAB (Frontal Assessment Battery) methods and MMSE test. Results. Total IES-R score at the first day after the injury was statistically and significantly higher in the II group due to “invasion subscale” and especially “physiological excitability subscale” scores. However, “avoiding” subscale score was significantly lower in wounded than in non-combat victims. At admission cognitive functions in non-combat and combat trauma patients were characterized primarily by attention and short-term memory impairment. In course of time severity of cognitive impairment gradually decreased. Conclusions. Long-term combat-related stress causes more pronounced cognitive impairment than non-combat accidents. Attention and short-term memory were most impaired of all cognitive functions in both groups. The difficulties were also noted insensitivity to interference and inhibitory control. The highest cognitive functions inhibition was observed on the 7th day after injury.
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