Disability and quality of life 20 years after traumatic brain injury

Abstract

ObjectivesThe study describes functional outcomes and health‐related quality of life (HRQL) in patients with traumatic brain injury (TBI) 20 years postinjury.Materials and MethodsForty‐four survivors who acquired moderate and severe TBI during 1995–1996 were followed 10 and 20 years postinjury. Outcomes were Glasgow Outcome Scale Extended (GOSE), Community Integration Questionnaire (CIQ), and SF‐36 questionnaire (SF‐36). Multiple regressions were performed to examine the relationship between follow‐up measurements, controlling for baseline demographics and injury severity.ResultsThere were no significant differences in baseline age and civil status between moderate and severe TBI, but patients with severe injury had significantly lower employment rates (p = 0.05). Mean age at 20‐years follow‐up was 50.8 (SD 11.4) years, and 73% were males. Most patients showed good recovery (52%) or moderate disability (43%). Disability levels remained stable between and within severity groups from 10 to 20 years. Community integration including social integration improved from 10 to 20 years (p = 0.01 and p = 0.005, respectively). HRQL remained stable, except for subscales Bodily Pain and Role Emotional (p = 0.02 and p = 0.06). Depression at 10 years and females were associated with poorer mental health, while productive activity at 10 years indicated better physical and mental health at 20 years postinjury, respectively.ConclusionsFunctional limitations persist even decades after moderate and severe TBI, with poorer prognosis for females and persons who were depressed at the 10‐year follow‐up. Development and evaluation of targeted long‐term follow‐up programs and access to rehabilitation services for these groups should be highlighted. Improved community integration despite stable functional limitations draws attention to long‐term adaptation to adversity and illness.

Family experiences up to seven years after a severe traumatic brain injury–family interviews

“…Still, there is an absence of studies focusing on the process of transition for STBI families as a whole with the injured person included, especially in a long-term perspective. Our study, like other studies, confirms that prognoses after STBI differ [42] and that even many years after STBI disability some minor or more prominent needs and changes still exist [43]. Families in our study, as long as up to 7 year after injury, described unmet needs and lack of professional support to alleviate the burden and sense of loneliness or social isolation.…”

Mental Health and Family Functioning in Patients and Their Family Members after Traumatic Brain Injury: A Cross-Sectional Study

“…To form a more comprehensive picture of the challenges that families face after TBI, it is important to include the perspectives of both the patients and their family members [ 20 ]. Previous research has demonstrated that personal, familial, and social characteristics and injury severity affect HRQL, disease burden, and family adjustment after TBI [ 21 , 22 , 23 ]. However, there is a paucity of knowledge on mental health and family functioning related to the consequences of TBI, which include the impact on these outcomes for members within the same family system.…”

Functional outcome, in-hospital healthcare consumption and in-hospital costs for hospitalised traumatic brain injury patients: a Dutch prospective multicentre study

“…The increase in mortality rates (12.3 to 15%) and data on persisting deficits and disabilities after 6 months confirm the need for increased vigilance and attention for rehabilitation or long-term care opportunities. Sustained health problems after TBI have also been reported by long-term follow up studies [21,42,52,74], some reporting deterioration between 5 and 10 years [17], others reporting remaining functional limitations up to 20 years after moderate and severe TBI [3]. Long-term impairments are not limited to severe TBI, but are also reported after mild TBI [14,68].…”