Research Reports - Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury
Acta Neurol Scand. 2013 Apr 29
Forslund MV, Roe C, Sigurdardottir S, Andelic N
AIMS: To describe health-related quality of life (HRQL) 2 years after
moderate-to-severe traumatic brain injury (TBI) and to assess predictors of HRQL.
MATERIALS AND METHODS: A prospective cohort study of 91 patients, aged
16-55 years, admitted with moderate-to-severe TBI to a trauma referral centre
between 2005 and 2007, with follow-up at 1 and 2 years. Mean age was 31.1
(SD = 11.3) years, and 77% were men. Injury severity was evaluated by the Glasgow
Coma Scale (GCS), head CT scan (using a modified Marshall Classification), Injury
Severity Score (ISS) and post-traumatic amnesia (PTA). The Functional
Independence Measure (FIM), Community Integration Questionnaire (CIQ), Beck
Depression Inventory (BDI) and Medical Outcomes 36-item Short Form Health Survey
(SF-36) were administered at follow-up visits. The main outcome measures were the
Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36.
RESULTS: HRQL appears to be relatively stable between 1 and 2 years after injury.
In the multivariate linear regression, younger age (β = -0.20, P = 0.032), more
severe TBI (β = 0.28, P = 0.016), more severe overall trauma (β = 0.22,
P = 0.026), higher levels of community integration (β = 0.36, P = 0.019) and
higher positive change in PCS scores from 1 to 2 years (β = 0.41, P < 0.001)
predicted better self-reported physical health 2 years post-TBI. Lower scores for
depression (β = -0.70, P < 0.001) and a higher positive change in MCS scores
(β = 0.62, P < 0.001) predicted better self-reported mental health. CONCLUSIONS:
Future interventions should focus on aspects related to HRQL that are more easily
modified, such as physical functioning, home and social integration,
productivity, and mental and emotional status.