Predictors of functional and professional outcomes in patients with severe traumatic brain injury

Boudokhane, S.; Brahim, H. Ben; Salah, Aymen Haj; Migaou, H.; Jellad, A.; Frih, Z. Ben Salah

doi:10.1016/j.rehab.2016.07.301

Cited by 6 publications

(5 citation statements)

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“…33 In the present study, approximately 35% of the patients have reported varying degrees of disability which is slightly lesser compared with more than 40% reported in previous literature. 12,34 Functional disabilities of the patients were found to be affecting the daily activities such as feeding difficulties and employment status. In our patients, only 4% of the patients were employable while 24% of patients were not employable for the jobs they were already performing.…”

Section: Discussionmentioning

confidence: 99%

“…Other associated injuries such as spinal cord or peripheral nerve injuries, fractures and amputations can also be the cause of functional disabilities in patients. 9,12,34 Functional impairment is also related to depressive signs in patients of TBI. 9 The family caregivers of patients with TBI in our study reported a certain level of burden due to lack of time, stress while giving care, financial burden, etc.…”

Section: Discussionmentioning

confidence: 99%

“…The scoring of MMSE is from 0 to 30, where lower the score higher the degree of cognitive impairment. A score of 24 or more describes the normal cognition and the cognitive deficit is graded based on the score as mild (20)(21)(22)(23)(24)(25), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), or severe (≤9). 19 We used the Neuropsychiatric Inventory Questionnaire (NPI-Q) to quantify the number of behavioral changes in the patients.…”

Section: Instrumentsmentioning

confidence: 99%

“…Functional problems faced by TBI survivors that affect rehabilitation and personal or social life include difficulty in walking, voiding, feeding, and inability to self-care. [11][12][13] TBI recovery and outcomes generally affect the caregiver's well-being and can lead to caregiver burden. The caregiver burden is stress, which is perceived by caregivers due to the patient's chronic illness or disabilities during the home care situation.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive, Behavioral, and Functional Impairments among Traumatic Brain Injury Survivors: Impact on Caregiver Burden

Devi

Khan

Rana

et al. 2020

JNRP

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Background The burden of cognitive, behavioral, and functional impairments after traumatic brain injury (TBI) is still not highlighted much, but its impact on caregivers is socio-economically relevant. The objectives of the study were to assess cognitive, behavioral, and functional impairments in patients of TBI and its impact on caregiver burden. Materials and Methods A descriptive cross-sectional study was conducted using a total enumeration sampling technique. Mini-mental status examination, neuropsychiatric inventory and Rappaport’s disability rating scale were used to assess patients’ cognitive, behavioral, and functional impairments, respectively. Zarit Caregiver Burden Scale was executed to quantify the caregiver burden. Results Fifty patients of TBI and their caregivers were enrolled. Among these, 24% had moderate cognitive impairments. Among behavioral symptoms, 40% had agitation, 24% had depression, 18% had anxiety, and 16% had irritability. Moderate functional disability was reported by 18% of the patients, while 2% reported severe functional disability. Moderate to severe caregiver burden was reported by 8% of caregivers. Patients’ behavioral (r = 0.507, p < 0.001), functional (r = 0.473, p = 0.001), and cognitive (r = –0.438, p = 0.001) impairments had significant correlations with caregiver burden. Conclusion Patients develop cognitive, behavioral, and functional disability after TBI. The caregiver burden increases significantly with cognitive dysfunction, behavioral symptoms, and impaired functional status of patients. Therefore, appropriate support is to be provided to caregivers as well as patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Instrumentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cognitive, Behavioral, and Functional Impairments among Traumatic Brain Injury Survivors: Impact on Caregiver Burden

Devi

Khan

Rana

et al. 2020

JNRP

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“…TBI patients can experience a loss in physical, behavioural or emotional functioning after the injury [ 5 ]. Severe TBI often results in motor impairment that persists for at least 3 years after the injury [ 6 ] and cognitive impairments are present for at least 6 months after injury [ 7 ]. Problems with memory following TBI significantly affect an individual’s quality of life [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

A nested mechanistic sub-study into the effect of tranexamic acid versus placebo on intracranial haemorrhage and cerebral ischaemia in isolated traumatic brain injury: study protocol for a randomised controlled trial (CRASH-3 Trial Intracranial Bleeding Mechanistic Sub-Study [CRASH-3 IBMS])

Mahmood¹,

Roberts²,

Shakur³

2017

Trials

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BackgroundTranexamic acid prevents blood clots from breaking down and reduces bleeding. However, it is uncertain whether tranexamic acid is effective in traumatic brain injury. The CRASH-3 trial is a randomised controlled trial that will examine the effect of tranexamic acid (versus placebo) on death and disability in 13,000 patients with traumatic brain injury. The CRASH-3 trial hypothesizes that tranexamic acid will reduce intracranial haemorrhage, which will reduce the risk of death. Although it is possible that tranexamic acid will reduce intracranial bleeding, there is also a potential for harm. In particular, tranexamic acid may increase the risk of cerebral thrombosis and ischaemia. The protocol detailed here is for a mechanistic sub-study nested within the CRASH-3 trial. This mechanistic sub-study aims to examine the effect of tranexamic acid (versus placebo) on intracranial bleeding and cerebral ischaemia.MethodsThe CRASH-3 Intracranial Bleeding Mechanistic Sub-Study (CRASH-3 IBMS) is nested within a prospective, double-blind, multi-centre, parallel-arm randomised trial called the CRASH-3 trial. The CRASH-3 IBMS will be conducted in a cohort of approximately 1000 isolated traumatic brain injury patients enrolled in the CRASH-3 trial. In the CRASH-3 IBMS, brain scans acquired before and after randomisation are examined, using validated methods, for evidence of intracranial bleeding and cerebral ischaemia. The primary outcome is the total volume of intracranial bleeding measured on computed tomography after randomisation, adjusting for baseline bleeding volume. Secondary outcomes include progression of intracranial haemorrhage (from pre- to post-randomisation scans), new intracranial haemorrhage (seen on post- but not pre-randomisation scans), intracranial haemorrhage following neurosurgery, and new focal ischaemic lesions (seen on post-but not pre-randomisation scans). A linear regression model will examine whether receipt of the trial treatment can predict haemorrhage volume. Bleeding volumes and new ischaemic lesions will be compared across treatment groups using relative risks and 95% confidence intervals.DiscussionThe CRASH-3 IBMS will provide an insight into the mechanism of action of tranexamic acid in traumatic brain injury, as well as information about the risks and benefits. Evidence from this trial could inform the management of patients with traumatic brain injury.Trial registrationThe CRASH-3 trial was prospectively registered and the CRASH-3 IBMS is an addition to the original protocol registered at the International Standard Randomised Controlled Trials registry (ISRCTN15088122) 19 July 2011, and ClinicalTrials.gov on 25 July 2011 (NCT01402882).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2073-6) contains supplementary material, which is available to authorized users.

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Health-related quality of life in trauma patients at 12 months after injury: a prospective cohort study

Tamura

Kuriyama

Kaihara

2018

Eur J Trauma Emerg Surg

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Predictors of functional and professional outcomes in patients with severe traumatic brain injury

Cited by 6 publications

References 0 publications

Cognitive, Behavioral, and Functional Impairments among Traumatic Brain Injury Survivors: Impact on Caregiver Burden

Cognitive, Behavioral, and Functional Impairments among Traumatic Brain Injury Survivors: Impact on Caregiver Burden

A nested mechanistic sub-study into the effect of tranexamic acid versus placebo on intracranial haemorrhage and cerebral ischaemia in isolated traumatic brain injury: study protocol for a randomised controlled trial (CRASH-3 Trial Intracranial Bleeding Mechanistic Sub-Study [CRASH-3 IBMS])

Health-related quality of life in trauma patients at 12 months after injury: a prospective cohort study

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