Health-Related Quality of Life Trajectories across 10 Years after Moderate to Severe Traumatic Brain Injury in Norway

Abstract

Traumatic brain injury (TBI) has a long-lasting impact on participation and health-related quality of life (HRQL). We aimed to describe the physical and mental health trajectories and to identify their predictors across the first 10 years after TBI. A prospective longitudinal cohort of 97 individuals with moderate to severe TBI (age 16–55 years) in Norway were followed up at 1, 2, 5, and 10 years post-injury. Their socio-demographic and injury characteristics were recorded at baseline; their responses to the 36-Item Short Form Health Survey (SF-36) were collected at each follow-up. The Physical (PCS) and Mental Component Summary (MCS) scores were used as the outcome measures of physical and mental health. The predictors of the trajectories were described and examined using hierarchical linear modelling. The subscale scores showed a stable or increasing trend, but only the Role Physical and Role Emotional subscales showed clinically relevant positive changes from 1 to 10 years post-injury. Longer time, male gender, employment pre-injury, and shorter length of post-traumatic amnesia were significant predictors of better physical health trajectories; longer time, male gender, and employment pre-injury were significant predictors of better mental health trajectories. At-risk individuals may be targeted to receive rehabilitation interventions to improve their long-term quality of life outcomes.

Goal Attainment in an Individually Tailored and Home-Based Intervention in the Chronic Phase after Traumatic Brain Injury

“…Persons who suffer a TBI might experience a variety of consequences, including difficulties with physical, cognitive, emotional, behavioral, vocational, and social functioning. Many experience persistently reduced quality of life and restrictions in community participation [4][5][6][7][8][9]. Families are also affected and may have to adapt to a new life with their injured family member being dependent on their assistance and support [10][11][12][13][14].…”

In the Aftermath of Acute Hospitalization for Traumatic Brain Injury: Factors Associated with the Direct Pathway into Specialized Rehabilitation

“…The physical, cognitive and emotional consequences of traumatic brain injury (TBI) may have a substantial negative impact on daily life functioning and quality of life [1,2]. The goal of TBI rehabilitation is to maximize the final outcome and preferably restore the preinjury functional level.…”

Health and Well-Being of Persons of Working Age up to Seven Years after Severe Traumatic Brain Injury in Northern Sweden: A Mixed Method Study

“…With the exception of the age factor, our study is in line with a recent multi-centre study which found that women reported more severe outcomes, depending on TBI severity and older age [ 24 ]. A recent prediction study reported that women, persons who were unemployed before injury and persons with more severe TBI at 10-year follow-up had lower HRQL, suggesting that these persons should perhaps be targeted for regular follow-up [ 62 ]. However, there were only seven female participants in our study, and, therefore, it is not possible to draw any major conclusions regarding whether being a woman has any significance for the outcome.…”