2)Develop annotation schema and a training set of annotated documents to support the future ... at the James A. Haley Hospital in Tampa, Florida. Participants: ...
Brain Injury to hospitalized patients with orthopedic trauma (OT); To qualitatively examine preliminary associations between sleep, neurorecoveryand cognitive statusfor those with TBI. Design: Cross sectional evaluation of polysomnographic recordings. Setting: Level 1 Regional Trauma Centre Participants: Hospitalized patients with acute moderate-severe traumatic brain injury or orthopedic trauma. Interventions: NA Main Outcome Measure(s): Polysomnographic (PSG) measures of: Total Sleep Time (TST), Sleep Efficiency, Number, Duration of awakenings, Percentage of each Sleep Stage and Rapid Eye Movement (REM) sleep characteristics. Rancho Los Amigos(RLA) Level of Cognitive Functioning and Galveston Orientation and Amnesia Test (GOAT). Results: No significant between group differences were noted for total sleep duration. However, during the sleep period the TBI participants (NZ8, 4Males mean age 24.3 + 10.5yrs)spent>50% time awake; 156.6 109.5 minutes as compared to 76.1 42.7 for the OT participants (NZ5, 3 males).Total number of awakenings within the sleep period was greater for the TBI group; 47.7 33.11 compared to 33.2 15.6 (OT). Within the TBI group, shorter total sleep time and increased number and duration of awakenings were associated with delayed resolution of post traumatic amnesia, poorer RLA and GOAT scores at hospital discharge. Conclusions: These preliminary results indicate that hospitalized patients with acute moderate-severe TBI have increased TST compared to those with orthopedic trauma, but poor sleep efficiency(fragmented sleep with multiple awakenings).Multiple fragmentations are associated with slower cognitive recovery for those with TBI.Improving sleep in the early stages post TBI mayfacilitate recovery. Key Words: sleep, traumatic brain injury, cognition, neurorecovery Disclosure(s): None disclosed. Poster 151 Using the Electronic Health Record to Improve Measurement of Unemployment in Veterans With TBI Dezon Finch, Christina Dillahunt-Aspillaga (USF- Department of Rehabilitation and Mental Health Counseling), Stephen Luther, James A. McCart Objective: 1) To determine if information about employment status, goals, and work-related barriers reported by service members and Veterans with mild traumatic brain injury (mTBI) and post-deployment stress is can be identified in the Electronic Health Record (EHR). 2)Develop annotation schema and a training set of annotated documents to support the future development of a natural language processing (NLP) system to extract employment information. Design: Retrospective cohort study data from selected progress notes stored in the EHR. Setting: Post-deployment Rehabilitation and Evaluation Program (PREP) at the James A. Haley Hospital in Tampa, Florida. Participants: Electronic records (NZ60) service members and Veterans with TBI who completed the PREP program. Interventions: Not applicable. Main Outcome Measure(s): Documentation of employment status, goals, and work-related barriers reported by service members and recorded in the EHR. Results: Two-hundred notes were examined and unique vocational information was found indicatinga variety of self- reported employment barriers and challenges. Current employment status and future vocational goals along with information about cognitive, physical, and behavioral symptoms that affect return- to work were extracted from the EHR. The annotation schema developed for this study provides an excellent tool upon which NLP studies can be developed. Conclusions: Information related to employment status and vocational history is stored as a text documents in the EHR system, but does not support easy summarization for research and rehabilitation planning
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e53 purposes. Using NLP systems, larger-scale retrospective and prospective studies necessary to improve the understanding and measurement of employment in this important cohort are possible. Key Words: Veterans, Traumatic Brain injury, Rehabilitation, Vocational, Employment Status, Unemployment Acknowledgement “Funding for this work was provided by VHA QUERI RRP 12-450. The views expressed in this work are those of the authors and do not necessarily reflect the position or policy of the Dept. of Veterans Affairs or the US Government.” Disclosure(s): Nothing further to disclose. Poster 152 Sensitivity of the Montreal Cognitive Assessment for Out-Patients With Mild Traumatic Brain Injury Cindy Hunt (St. Michael’s Hospital), Donna Ouchterlony Objective: We aimed to assess the sensitivity of the Montreal Cognitive Assessment (MoCA) to screen for cognitive impairments amongst patients with mild traumatic brain injury (mTBI) seen in an outpatient head injury clinic. Our research questions: 1) What proportion of assessed patients demonstrated cognitive impairments as per the MoCA? 2) What patient factors were associated with cognitive impairment as per the MoCA? Design: Cross sectional survey. Setting: Level 1 tertiary care urban outpatient head injury clinic. Participants: mTBI patients (nZ117) assessed between July 2013 and January 2014. Interventions: Not applicable. Main Outcome Measure(s): MoCA overall and sub-component scores. Results: Patients were assessed on average 37 weeks (range 0-329 weeks) post-injury. Overall, 41.8% (nZ49) were cognitively impaired as per the MoCA (score
