What contributes to quality of life in adult survivors of childhood traumatic brain injury?

Adult outcome from childhood brain injury is largely unknown, and health professionals have minimal evidence available to inform families about their child's long-term prognosis. This study aimed to investigate long-term outcomes in this group, focusing on quality of life (QOL) and the injury, developmental, and environmental factors that influence this domain, using a retrospective and cross-sectional design. The sample was ascertained via medical record audit at the Royal Children's Hospital, Melbourne, Australia, and included 130 adult survivors of child traumatic brain injury (TBI) (84 men). Participants were 18-42 years at evaluation (mean = 23.2, SD = 3.3) and completed questionnaires regarding QOL and educational, employment, and psychological status. Analysis of variance, chi-square, and regression were employed to assess group differences and predictors of outcome. While most adult survivors of childhood TBI rated their QOL as intact, 17% of the sample reported poor QOL. Poor QOL was more likely with low levels of perceived independence, severe TBI, younger age at injury, failure to complete high school, and psychological problems. In conclusion, QOL in adult survivors of childhood TBI is better than expected and closely associated with both injury and noninjury factors, most consistently with the individual's perception of their level of independence.