Article

OBJECTIVES: To evaluate the time course of health-related quality of life (HRQoL)
after moderate to severe traumatic brain injury (TBI) and to identify its
predictors. DESIGN: Prospective cohort study with follow-up measurements at 3, 6,
12, 18, 24, and 36 months after TBI. SETTING: Patients with moderate to severe
TBI discharged from 3 level-1 trauma centers. PARTICIPANTS: Patients (N=97, 72%
men) with a mean age +/- SD of 32.8+/-13.0 years (range, 18-65y), hospitalized
with moderate (23%) or severe (77%) TBI. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: HRQoL was measured with the Medical Outcomes Study 36-Item
Short-Form Health Survey (SF-36), functional outcomes with the Glasgow Outcome
Scale (GOS), Barthel Index, FIM, and Functional Assessment Measure, and mood with
the Wimbledon Self-Report Scale. RESULTS: The SF-36 domains showed significant
improvement over time for Physical Functioning (P<.001), Role Physical (P<.001),
Bodily Pain (P<.001), Social Functioning (P<.001), and Role Emotional (P=.024),
but not for General Health (P=.263), Vitality (P=.530), and Mental Health
(P=.138). Over time there was significant improvement in the Physical Component
Summary (PCS) score, whereas the Mental Component Summary (MCS) score remained
stable. At 3-year follow-up, HRQoL of patients with TBI was the same as that in
the Dutch normative population. Time after TBI, hospital length of stay (LOS),
FIM, and GOS were independent predictors of the PCS, whereas LOS and mood were
predictors of the MCS. CONCLUSIONS: After TBI, the physical component of HRQoL
showed significant improvement over time, whereas the mental component remained
stable. Problems of disease awareness seem to play a role in self-reported mental
HRQoL. After TBI, mood status is a better predictor of the mental component of
HRQoL than functional outcome, implying that mood should be closely monitored
during and after rehabilitation.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS