Long-term outcomes after moderate-to-severe traumatic brain injury among military veterans: Successes and challenges

Schulz-Heik, R. Jay; Poole, John H.; Dahdah, Marie; Sullivan, Campbell; Date, Elaine S.; Salerno, Rose Marie; Schwab, Karen; Harris, Odette A.

doi:10.3109/02699052.2015.1113567

Cited by 23 publications

(16 citation statements)

References 32 publications

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“…However, a very small sample of participants (4%) had severe disability. These values are consistent with the findings of previous studies (McMillan et al., ; Schulz‐Heik et al., ). Roughly two‐thirds of the patients with moderate TBI revealed good recovery in contrast to one‐third of patients with severe TBI indicating a long‐term differential effect of severe and moderate TBI which is in line with findings from previous research (Forslund et al., ; Ponsford et al., ).…”

Section: Discussionsupporting

confidence: 93%

“…A large proportion of patients with moderate and severe traumatic brain injury (TBI) sustain long‐term physical, cognitive, and emotional impairments that have a deep impact on their functioning, reintegration to society and health‐related quality of life (HRQL; Andelic et al., ; Forslund, Roe, Sigurdardottir, & Andelic, ; Hammond et al., ; Jacobsson, Westerberg, Soderberg, & Lexell, ; Ponsford, Draper, & Schonberger, ; Schulz‐Heik et al., ; Sigurdardottir, Andelic, Roe, & Schanke, ; Wilson et al., ). TBI outcomes up to 10 years postinjury have been documented in several studies (Andelic et al., , ; Dahm & Ponsford, ; Jourdan et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Disability and quality of life 20 years after traumatic brain injury

et al. 2018

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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.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Disability and quality of life 20 years after traumatic brain injury

et al. 2018

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“…As highlighted previously (LeBlanc et al., ; Marquez de la Plata et al., ) and despite experiencing milder head injuries, middle‐aged individuals showed lower levels of functional recovery and were less incline to have reintegrated work and/or school than young TBI survivors. While older TBI adults may truly have poorer recovery potential than younger ones, they are also more likely to be pushed into early retirement (Schulz‐Heik et al., ) and to score <7 on the GOS‐E for that reason. Nonetheless, age was not found to be a significant predictor of functional recovery in adults of working age.…”

Section: Discussionmentioning

confidence: 99%

Does age matter? A mixed methods study examining determinants of good recovery and resilience in young and middle‐aged adults following moderate‐to‐severe traumatic brain injury

Arbour

Gosselin

Levert

et al. 2017

Journal of Advanced Nursing

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“…Despite this, the majority were able to work in civilian roles. Return to alternative work is therefore possible despite neurological impairment preventing them ‘returning to work’ (noted in military veterans elsewhere) 38. Thus employment for all should be considered the norm and alternative employment should always be explored.…”

Section: Discussionmentioning

confidence: 99%

Long-term employment outcomes following rehabilitation for significant neurological impairment in UK military personnel: a 3-year study

Bahadur¹,

McRann²,

McGilloway³

2017

J R Army Med Corps

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Despite significant brain/neurological injury (graded by severity/Mayo Portland Adaptability Inventory 4), 80.7% (76-85) were working/training 2/3 years postdischarge from neurorehabilitation with 31.7% returning to full-time military role. Inability to continue within the military was not synonymous with inability to work. Return to work was independent of severity of brain/neurological injury and follow-up over consecutive years demonstrated sustained employment. The argument against inpatient neurorehabilitation has always been cost> This 3-year analysis reinforces that patients can and most likely will return to employment with all the benefits this brings to person/family/society. Vocational rehabilitation is therefore recommended for all brain/neurological injury.

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Long-term outcomes after moderate-to-severe traumatic brain injury among military veterans: Successes and challenges

Cited by 23 publications

References 32 publications

Disability and quality of life 20 years after traumatic brain injury

Disability and quality of life 20 years after traumatic brain injury

Does age matter? A mixed methods study examining determinants of good recovery and resilience in young and middle‐aged adults following moderate‐to‐severe traumatic brain injury

Long-term employment outcomes following rehabilitation for significant neurological impairment in UK military personnel: a 3-year study

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