BACKGROUND: To investigate the long-term outcome in polytrauma victims with traumatic brain injury (TBI) and without traumatic brain injury (NTBI). METHODS: Cohort study based on prospectively collected data. Evaluation of functional outcome and quality of life at least 2 years (median 2.5) following trauma in 111 survivors [39.5 ± 20.9 years; injury severity score (ISS) 27.9 ± 8.2; TBI: n = 45; NTBI: n = 66] out of a total of 211 consecutive multiply-injured patients with an ISS > 16, all primarily admitted to the intensive care unit. RESULTS: Significantly fewer TBI patients lived independently compared with NTBI patients (71% vs. 95%; P < 0.001). TBI patients showed a higher decrease in their capacity to work compared with NTBI patients (P < 0.002). Both study groups experienced a significantly reduced long-term outcome in comparison with pre-injury level in all dimensions of the short form (SF)-36. Following stepwise logistic regression, the mental sum component of the SF-36 and the Nottingham Health Profile discriminated independently between TBI and NTBI patients (R(2) = 0.219; P < 0.001). CONCLUSION: More than 2 years after injury, polytraumatized patients with and without TBI suffer from a reduction in functional outcome and quality of life, but TBI patients are doing importantly worse. Any comparison of trauma patient cohorts should consider these differences between TBI and NTBI patients. Given their discriminatory potential, the sensitivity of self-reported measures needs further affirmation with neuropsychological assessments.
BACKGROUND: To investigate the long-term outcome in polytrauma victims with traumatic brain injury (TBI) and without traumatic brain injury (NTBI). METHODS: Cohort study based on prospectively collected data. Evaluation of functional outcome and quality of life at least 2 years (median 2.5) following trauma in 111 survivors [39.5 ± 20.9 years; injury severity score (ISS) 27.9 ± 8.2; TBI: n = 45; NTBI: n = 66] out of a total of 211 consecutive multiply-injured patients with an ISS > 16, all primarily admitted to the intensive care unit. RESULTS: Significantly fewer TBI patients lived independently compared with NTBIpatients (71% vs. 95%; P < 0.001). TBI patients showed a higher decrease in their capacity to work compared with NTBIpatients (P < 0.002). Both study groups experienced a significantly reduced long-term outcome in comparison with pre-injury level in all dimensions of the short form (SF)-36. Following stepwise logistic regression, the mental sum component of the SF-36 and the Nottingham Health Profile discriminated independently between TBI and NTBIpatients (R(2) = 0.219; P < 0.001). CONCLUSION: More than 2 years after injury, polytraumatized patients with and without TBI suffer from a reduction in functional outcome and quality of life, but TBI patients are doing importantly worse. Any comparison of traumapatient cohorts should consider these differences between TBI and NTBIpatients. Given their discriminatory potential, the sensitivity of self-reported measures needs further affirmation with neuropsychological assessments.
Authors: Sandy R Shultz; Mujun Sun; David K Wright; Rhys D Brady; Shijie Liu; Sinead Beynon; Shannon F Schmidt; Andrew H Kaye; John A Hamilton; Terence J O'Brien; Brian L Grills; Stuart J McDonald Journal: J Cereb Blood Flow Metab Date: 2015-04-08 Impact factor: 6.200
Authors: Samuel M Brown; Emily Wilson; Angela P Presson; Chong Zhang; Victor D Dinglas; Tom Greene; Ramona O Hopkins; Dale M Needham Journal: Thorax Date: 2016-07-20 Impact factor: 9.139
Authors: Hagen Andruszkow; Julia Urner; Ezin Deniz; Christian Probst; Orna Grün; Ralf Lohse; Michael Frink; Frank Hildebrand; Christian Zeckey Journal: Patient Saf Surg Date: 2013-10-10
Authors: Belinda J Gabbe; Pam M Simpson; Ronan A Lyons; Shanthi Ameratunga; James E Harrison; Sarah Derrett; Suzanne Polinder; Gabrielle Davie; Frederick P Rivara Journal: PLoS One Date: 2014-12-11 Impact factor: 3.240
Authors: John K Yue; Gabriela G Satris; Cecilia L Dalle Ore; J Russell Huie; Hansen Deng; Ethan A Winkler; Young M Lee; Mary J Vassar; Sabrina R Taylor; David M Schnyer; Hester F Lingsma; Ava M Puccio; Esther L Yuh; Pratik Mukherjee; Alex B Valadka; Adam R Ferguson; Amy J Markowitz; David O Okonkwo; Geoffrey T Manley Journal: Neurotrauma Rep Date: 2020-07-23