Research Reports - Comparison of long-term outcomes following traumatic injury

Injury. 2015 Jan;46(1):142-9

Dahm J(1), Ponsford J(2)

OBJECTIVE: Whilst it has been well-demonstrated that traumatic brain injury (TBI)
results in long-term cognitive, behavioural and emotional difficulties, less is
understood about how these outcomes differ from those following traumatic
orthopaedic injury (TOI). The aim of this study was to compare self-reported
outcomes at 5-10 years post-injury for those with TBI, TOI, and uninjured
controls. It was hypothesised that participants with TBI would have greater
cognitive difficulties; participants with TOI and TBI would have similar
functional and physical outcomes, both being poorer than controls; and
participants with TBI would have poorer psychosocial outcomes than those with
TOI.
PARTICIPANTS AND METHODS: Eighty-eight individuals with complicated mild to
severe TBI and 96 with TOI recruited during inpatient rehabilitation were
followed up 5-10 years post-injury, together with 48 controls followed over a
similar period. Self-report measures of global functioning (GOS-E), quality of
life (SF-36), psychological wellbeing (SCL-90-R, HADS, PCL-S), psychosocial
difficulties (SIP), cognitive difficulties (SF-36 COG), pain (BPI), and fatigue
(FSS) were administered.
RESULTS: Outcomes for individuals with TBI and TOI differed significantly from
controls, with poorer global functioning, and greater psychological distress and
interference from pain. Only participants with TBI reported greater cognitive
difficulties and anxiety than controls, and were less likely to be employed or in
a relationship. Participants with TBI reported greater anxiety, PTSD,
psychological distress and psychosocial difficulties than those with TOI.
CONCLUSIONS: Both TOI and TBI cause long-term disability, interference from pain,
and psychological distress. However, cognitive impairments, unemployment, lack of
long-term relationships, anxiety and PTSD are more substantial long-term problems
following TBI. Findings from this study have implications for managing risks
associated with these injury groups and tailoring rehabilitation to improve
long-term outcomes.

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