Subjective impact of traumatic brain injury on long-term outcome at a minimum of 10 years after trauma– first results of a survey on 368 patients from a single academic trauma center in Germany

Andruszkow, Hagen; Urner, Julia; Deniz, E.; Probst, Christian; Grün, Orna; Lohse, R; Frink, Michael; Hildebrand, Frank; Zeckey, Christian

doi:10.1186/1754-9493-7-32

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…The investigation was designed as a retrospective cohort study at a level I trauma center. The clinical database was generated for this study including all patients with TBI at least 10 years after trauma referring to December 1 st 2009 [ 16 ]. Participants have not been involved to other studies.…”

Section: Methodsmentioning

confidence: 99%

Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

Andruszkow

Deniz

Urner

et al. 2014

Health Qual Life Outcomes

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BackgroundSeveral studies have indicated that younger age is associated with worse recovery after pediatric traumatic brain injury (TBI) compared to elder children. In order to verify this association between long-term outcome after moderate to severe TBI and patient’s age, direct comparison between different pediatric age groups as well as an adult population was performed.MethodsThis investigation represents a retrospective cohort study at a level I trauma center including patients with moderate to severe, isolated TBI with a minimum follow-up of 10 years. According to their age at time of injury, patients were divided in pre-school (0–7 years), school (8–17 years) and adult (18–65 years) patients. Physical examination and standardized questionnaire on physical and psychological aspects (Glasgow Outcome Scale, Barthel Index, Impact of Event Scale, Hospital Anxiety and Depression Scale, short form 12) were performed.Results135 traumatized patients were included. Physical and psychological long-term outcome was associated with injury severity but not with patients’ age at time of injury. Outcome recovery measured by Glasgow Outcome Scale was demonstrated with best results for pre-school aged children (p = 0.009). According to the Hospital Anxiety and Depression Scale an increased incidence of anxiety (p = 0.010) and depression (p = 0.026) was evaluated in older patients.ConclusionLong-term outcome perceptions after moderate to severe TBI presented in this study question current views of deteriorated recovery for the immature brain. The sustained TBI impact seemed not to reduce the child’s ability to overcome the suffered impairment measured by questionnaire based psychological, physical and health related outcome scores. These results distinguish the relevance of rehabilitation and family support in the long term.

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Section: Methodsmentioning

confidence: 99%

Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

Andruszkow

Deniz

Urner

et al. 2014

Health Qual Life Outcomes

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“…3. Reported mean GOS scores showed rather 'favourable' longterm outcome ranging from 3.8 to 4.4 [3,8,38].…”

Section: Glasgow Outcome Scalementioning

confidence: 98%

“…Follow-up ranged from 2 to 15 years. Follow-up periods up to 5 years were reported in 13 studies (65%) [1,4,7,8,26,38,41,42,57,78,90,92,93], periods from 5 to 10 years in five studies (25%) [36,47,68,73,81], and a follow-up of more than 10 years was reported in two studies (10%) [2,3].…”

Section: Study Characteristics and Study Qualitymentioning

confidence: 99%

“…Some studies reported all five categories [1,2,26], while one study only mentioned GOS 3, 4 and 5 percentages [41]. Four studies used mean or median scores [3,8,38,90]. Unfavourable outcomes ranged between 26 and 79% and favourable outcomes between 21 and 74%.…”

Section: Glasgow Outcome Scalementioning

confidence: 99%

“…The reported HADS scores (9.7, 11.7 and 11.7) [4,42,68] indicated that some patients (with a score of ≥ 11) could still be suffering from anxiety or depression [9]. Also, studies showed high rates of unemployment, 12.9% and 48% [3,73]. One study reported a FIM score of 87.4, which is below the threshold score of ≤ 108 that indicates limitations in activities of daily living (ADL) and need for assistance from another person [38].…”

Section: Other Outcomesmentioning

confidence: 99%

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Long-term outcome after severe traumatic brain injury: a systematic literature review

et al. 2022

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Background Expectation of long-term outcome is an important factor in treatment decision-making after severe traumatic brain injury (sTBI). Conclusive long-term outcome data substantiating these decisions is nowadays lacking. This systematic review aimed to provide an overview of the scientific literature on long-term outcome after sTBI. Methods A systematic search was conducted using PubMed from 2008 to 2020. Studies were included when reporting longterm outcome ≥ 2 years after sTBI (GCS 3-8 or AIS head score ≥ 4), using standardized outcome measures. Study quality and risk of bias were assessed using the QUIPS tool. Results Twenty observational studies were included. Studies showed substantial variation in study objectives and study methodology. GOS-E (n = 12) and GOS (n = 8) were the most frequently used outcome measures. Mortality was reported in 46% of patients (range 18-75%). Unfavourable outcome rates ranged from 29 to 100% and full recovery was seen in 21-27% of patients. Most surviving patients reported SF-36 scores lower than the general population. Conclusion Literature on long-term outcome after sTBI was limited and heterogeneous. Mortality and unfavourable outcome rates were high and persisting sequelae on multiple domains common. Nonetheless, a considerable proportion of survivors achieved favourable outcome. Future studies should incorporate standardized multidimensional and temporal long-term outcome measures to strengthen the evidence-base for acute and subacute decision-making. Highlights 1. Expectation of long-term outcome is an important factor in treatment decision-making for patients with severe traumatic brain injury (sTBI). 2. Favourable outcome and full recovery after sTBI are possible, but mortality and unfavourable outcome rates are high. 3. sTBI survivors are likely to suffer from a wide range of long-term consequences, underscoring the need for long-term and multi-modality outcome assessment in future studies. 4. The quality of the scientific literature on long-term outcome after sTBI can and should be improved to advance treatment decision-making.

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Head Injuries: Neurosurgical and Orthopedic Strategies

Stahel

Flierl

2016

The Poly-Traumatized Patient With Fractures

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Subjective impact of traumatic brain injury on long-term outcome at a minimum of 10 years after trauma– first results of a survey on 368 patients from a single academic trauma center in Germany

Cited by 9 publications

References 31 publications

Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

Long-term outcome after severe traumatic brain injury: a systematic literature review

Head Injuries: Neurosurgical and Orthopedic Strategies

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