A comprehensive picture of 4-year outcome of severe brain injuries. Results from the PariS-TBI study

Jourdan, C.; Bayen, É.; Pradat‐Diehl, Pascale; Ghout, Idir; Darnoux, E.; Azerad, S.; Vallat‐Azouvi, Claire; Charanton, James; Aegerter, Philippe; Ruet, A.; Azouvi, Philippe

doi:10.1016/j.rehab.2015.10.009

Cited by 99 publications

(65 citation statements)

References 33 publications

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“…The majority of all psychiatric disorders (56.5%) post-TBI, and two-thirds of PTD diagnoses specifically,9 were first-time diagnoses. Point prevalence rates of psychiatric disorders up to 20 years post-TBI ranged from 17% to 31%,2,10–14 with a systematic review from 2011 estimating a point prevalence of 30% across multiple time points post moderate to severe TBI 15. Cumulative prevalence rates for PTD were higher, just over 50%,3,9,16 indicating that more than half of individuals with TBI will experience a depressive episode after injury.…”

Section: Discussionmentioning

confidence: 99%

A narrative literature review of depression following traumatic brain injury: prevalence, impact, and management challenges

Juengst¹,

Kumar²,

Wagner³

2017

PRBM

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Depression is one of the most common conditions to emerge after traumatic brain injury (TBI), and despite its potentially serious consequences it remains undertreated. Treatment for post-traumatic depression (PTD) is complicated due to the multifactorial etiology of PTD, ranging from biological pathways to psychosocial adjustment. Identifying the unique, personalized factors contributing to the development of PTD could improve long-term treatment and management for individuals with TBI. The purpose of this narrative literature review was to summarize the prevalence and impact of PTD among those with moderate to severe TBI and to discuss current challenges in its management. Overall, PTD has an estimated point prevalence of 30%, with 50% of individuals with moderate to severe TBI experiencing an episode of PTD in the first year after injury alone. PTD has significant implications for health, leading to more hospitalizations and greater caregiver burden, for participation, reducing rates of return to work and affecting social relationships, and for quality of life. PTD may develop directly or indirectly as a result of biological changes after injury, most notably post-injury inflammation, or through psychological and psychosocial factors, including pre injury personal characteristics and postinjury adjustment to disability. Current evidence for effective treatments is limited, although the strongest evidence supports antidepressants and cognitive behavioral interventions. More personalized approaches to treatment and further research into unique therapy combinations may improve the management of PTD and improve the health, functioning, and quality of life for individuals with TBI.

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Section: Discussionmentioning

confidence: 99%

A narrative literature review of depression following traumatic brain injury: prevalence, impact, and management challenges

Juengst¹,

Kumar²,

Wagner³

2017

PRBM

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“…Patients with acquired brain injury, such as traumatic brain injury (TBI) or stroke, may suffer from a wide range of motor, sensory, and cognitive/behavioral impairments, which may hinder social reintegration and family functioning (Jourdan et al, ; Ponsford et al, ). Assessment of these disorders may be difficult, raising a number of issues, including sensitivity/specificity of testing, test/retest effects, or ecological validity.…”

Section: Introductionmentioning

confidence: 99%

Subjective complaints after acquired brain injury: presentation of the Brain Injury Complaint Questionnaire (BICoQ)

Vallat‐Azouvi

Paillat

Bercovici

et al. 2017

J of Neuroscience Research

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The objective of the present study was to present a new complaint questionnaire designed to assess a wide range of difficulties commonly reported by patients with acquired brain injury.Patients (n 5 619) had been referred to a community re-entry service at a chronic stage after brain injury, mainly traumatic brain injury (TBI). The Brain Injury Complaint Questionnaire (BICoQ) includes 25 questions in the following domains: cognition, behavior, fatigue and sleep, mood, and somatic problems. A self and a proxy questionnaire were given. An additional question was given to the relative, about the patient's awareness of his difficulties. The questionnaires had a good internal coherence, as measured with Cronbach's alpha. The most frequent complaints were, in decreasing order, mental slowness, memory troubles, fatigue, concentration difficulties, anxiety, and dual tasking problems. Principal component analysis with varimax rotation yielded six underlying factors explaining 50.5% of total variance: somatic concerns, cognition, and lack of drive, lack of control, psycholinguistic disorders, mood, and mental fatigue/slowness. About 52% of patients reported fewer complaints than their proxy, suggesting lack of awareness. The total complaint scores were not significantly correlated with any injury severity measure, but were significantly correlated with disability and poorer quality of life (Note: only factor 2 [cognition/lack of drive] was significantly related to disability.) The BICoQ is a simple scale that can be used in addition to traditional clinical and cognitive assessment measures, and to assess awareness of everyday life problems.

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“…Los grados de discapacidad severa-moderada-buena recuperacion encontrados en el estudio no estuvieron acordes a publicaciones contemporáneas, según Jourdan y cols. 6 la discapacidad relacionado con el TCE se presento un 32% severa-muerte, 40% moderada y un 28% de buena recuperación comparada con 59,38%, 31,25% y 9,3% respectivamente en nuestro estudio. Es decir, los buenos resultados fueron minimos y los peores desenlaces incluyendo muerte fueron casi el doble con respecto a la literatura; teniendo en cuenta los protocolos establecidos y las indicaciones quirúrgicas en términos de trauma, se puede inferir que mas alla de la severidad del trauma primario se deben complemetar las opciones terapéuticas ofrecidas, siguiendo las recomendaciones mundiales para promover mejores resultados.…”

Section: Discusionunclassified

Estado Funcional De Los Pacientes Con Trauma Craneo Encefalico Criticamente Enfermos

Botache¹,

Sanjuán²,

Rubio³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Antecedentes: El trauma craneoencefálico (TCE) continúa siendo la principal causa de morbimortalidad entre pacientes con trauma, la discapacidad y el compromiso cognitivo corresponde a la principal afectación configurando pronóstico a largo plazo. Materiales y métodos:Se realizó un estudio prospectivo tipo cohortes/casos y controles donde se incluyeron los pacientes con TCE severo (Escala Coma de Glasgow <8 y/o TAC anormal) que ingresaron a la unidad de cuidados intensivos Adultos durante 6 meses; se buscó determinar los desenlaces relacionados con el TCE en términos de mortalidad y discapacidad.Resultados: Se encontraron 32 pacientes, más del 90% hombres, la mayoría con estabilidad hemodinámica al ingreso, se practicó neurocirugía en el 40% de los pacientes, aunque todos tenían indicación de monitoria de presión intracraneana solo se realizó en el 6% de los pacientes. El puntaje en la escala de desenlaces de Glasgow presento una mediana de 3 (RIC = 225 puntos). Se clasifico la severidad de la discapacidad en buena recuperacion 9,3%, discapacidad moderada 31,25%, discapacidad severa-muerte hasta en un 25%. Se determino que que un puntaje en la ECG se relacionaba con un GOS mas bajo; la neumonía aspirativa fue la principal complicación extracraneal, la mortalidad global correspondió a un 34.4%. Conclusión:El TCE continua afectando de manera especial a las poblaciones jóvenes, con una alta incidencia de consecuencias discapacitantes y alta mortalidad, los centros de trauma deben implementar protocolos mas estrictos para promover la prevención y reforzar la aplicación de recomendaciones mundiales para mejores resultados en términos supervivencia y calidad de vida.Significancia clinica: El trauma craneoencefálico, continua configurándose como la principal causa de morbimortalidad y discapacidad en adultos jovenes, con esta investigación se busca conocer y describir los datos epidemiológicos relevantes con respecto al desenlace de dicho trauma, conocimiento que es clave en el proceso de enseñanza buscando ofrecer mejores y mas efectivos abordajes en el momento de verse enfrentado a un trauma craneoencefálico.Palabras claves: Discapacidad, El trauma craneoencefálico, Escala pronostica de Glasgow, Monitoria de pic, Unidad de cuidados intensivos. ABSTRACTIntroduction: Traumatic brain injury (TBI) remains to be the leading cause of morbidity and mortality among patients with trauma, disability and neurocognitive commitment corresponds to the main affectation and set the long-term prognosis of these patients. Materials and methods:It was performed a prospective cohort/cases and controls study, where all the patients with severe TBI (Glasgow Coma Scale (GCS) < 8 and/or abnormal CT scan) were admitted into the adult intensive care unit (ICU) for 6 months to determine the outcomes related to TBI in terms of mortality and disability.Results: Thirty-two patients, more than 90% men, most with hemodynamic stability at admission; neurosurgery was practiced in 40% of patients. Although all had indication of intracranial pressure (...

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A comprehensive picture of 4-year outcome of severe brain injuries. Results from the PariS-TBI study

Abstract: Management of late brain injury needs to focus on cognitive difficulties, particularly social skills, to enhance patient participation in life.

Cited by 99 publications

References 33 publications

A narrative literature review of depression following traumatic brain injury: prevalence, impact, and management challenges

A narrative literature review of depression following traumatic brain injury: prevalence, impact, and management challenges

Subjective complaints after acquired brain injury: presentation of the Brain Injury Complaint Questionnaire (BICoQ)

Estado Funcional De Los Pacientes Con Trauma Craneo Encefalico Criticamente Enfermos

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