Thomas M McMillan1, Graham M Teasdale, Elaine Stewart. 1. Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK. thomas.mcmillan@glasgow.ac.uk
Abstract
BACKGROUND: There is a need to establish how long term outcome evolves after head injury (HI) and factors related to this, to inform opportunities for intervention. OBJECTIVE: To determine late outcome in adults 12-14 years after hospital admission for HI and to examine relationships between injury, early and late factors, and disability. METHODS: A prospective cohort with HI, whose outcome was reported previously at 1 and 5-7 years after injury, were followed up after 12-14 years. Participants were assessed using structured and validated measures of disability (Glasgow Outcome Scale-Extended), psychological well being, alcohol use and health status. RESULTS: Of 219 survivors followed-up at 5-7 years, 34 (15.5%) had died by 12-14 years. Disability remained common in survivors at 12-14 years (51%), as found at 1 and 5-7 years (53%). For those disabled at 1 year, outcome was poor, with 80% dead or disabled at 12-14 years. Older age at injury, a premorbid history of brain illness or physical disability and post-injury low self-esteem and stress were associated with disability at 12-14 years. Disability changed between 5-7 and 12-14 years in 55% of survivors, improving in 23%. Late changes in disability between 5-7 and 12-14 years were associated with self-perceptions of locus of control as being 'powerful others' at 5-7 years. CONCLUSIONS: Disability is common 12-14 years after hospital admission with a HI. For some there is a dynamic process of change in disability over time that is associated with self-perceptions of control that could be a target for intervention based research.
BACKGROUND: There is a need to establish how long term outcome evolves after head injury (HI) and factors related to this, to inform opportunities for intervention. OBJECTIVE: To determine late outcome in adults 12-14 years after hospital admission for HI and to examine relationships between injury, early and late factors, and disability. METHODS: A prospective cohort with HI, whose outcome was reported previously at 1 and 5-7 years after injury, were followed up after 12-14 years. Participants were assessed using structured and validated measures of disability (Glasgow Outcome Scale-Extended), psychological well being, alcohol use and health status. RESULTS: Of 219 survivors followed-up at 5-7 years, 34 (15.5%) had died by 12-14 years. Disability remained common in survivors at 12-14 years (51%), as found at 1 and 5-7 years (53%). For those disabled at 1 year, outcome was poor, with 80% dead or disabled at 12-14 years. Older age at injury, a premorbid history of brain illness or physical disability and post-injury low self-esteem and stress were associated with disability at 12-14 years. Disability changed between 5-7 and 12-14 years in 55% of survivors, improving in 23%. Late changes in disability between 5-7 and 12-14 years were associated with self-perceptions of locus of control as being 'powerful others' at 5-7 years. CONCLUSIONS: Disability is common 12-14 years after hospital admission with a HI. For some there is a dynamic process of change in disability over time that is associated with self-perceptions of control that could be a target for intervention based research.
Authors: Anaïs Virenque; Hennariikka Koivisto; Salli Antila; Emma Zub; Erin Jane Rooney; Diana Miszczuk; Adrian Müller; Enija Stoka; Nicola Marchi; Kari Alitalo; Heikki Tanila; Francesco Mattia Noe Journal: Brain Behav Immun Health Date: 2022-05-04
Authors: Lindsay Wilson; William Stewart; Kristen Dams-O'Connor; Ramon Diaz-Arrastia; Lindsay Horton; David K Menon; Suzanne Polinder Journal: Lancet Neurol Date: 2017-09-12 Impact factor: 59.935