C Jourdan1, E Bayen2, P Pradat-Diehl3, I Ghout4, E Darnoux4, S Azerad4, C Vallat-Azouvi5, J Charanton6, P Aegerter7, A Ruet8, P Azouvi9. 1. Département de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; UFR des sciences de la Santé-Simone Veil, HANDIReSP EA 4047, université de Versailles Saint-Quentin, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France. Electronic address: claire.jourdan@rpc.aphp.fr. 2. Laboratoire d'économie et de gestion des organisations de santé (LEDa-LEGOS), université Paris-Dauphine, 75016 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France; Service de médecine physique et de réadaptation, hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, AP-HP, 75013 Paris, France. 3. Université Pierre-et-Marie-Curie, 75005 Paris, France; Service de médecine physique et de réadaptation, hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, AP-HP, 75013 Paris, France. 4. Unité de recherche clinique (URC), hôpital Ambroise-Paré, AP-HP, 92012 Boulogne, France. 5. Département de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Pierre-et-Marie-Curie, 75005 Paris, France; Antenne UEROS-SAMSAH92-UGECAM IDF, hôpital Raymond-Poincaré, 92380 Garches, France. 6. Centre ressources francilien du traumatisme crânien (CRFTC), 75014 Paris, France. 7. Unité de recherche clinique (URC), hôpital Ambroise-Paré, AP-HP, 92012 Boulogne, France; UFR des sciences de la Santé-Simone Veil, UMR-S 1168, université de Versailles Saint-Quentin, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France. 8. Département de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France. 9. Département de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; UFR des sciences de la Santé-Simone Veil, HANDIReSP EA 4047, université de Versailles Saint-Quentin, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France.
Abstract
OBJECTIVES: Survivors of severe traumatic brain injury have a great variety of impairments and participation restrictions. Detailed descriptions of their long-term outcome are critical. We aimed to assess brain injury outcome for subjects with traumatic brain injury in terms of the International classification of functioning, disability and health. MATERIALS AND METHODS: Four-year follow-up of an inception cohort of adults with severe traumatic brain injury by using face-to-face interviews with patients and proxies. RESULTS: Among 245 survivors at 4 years, 147 were evaluated (80% male, mean age: 32.5±14.2 years at injury); 46 (32%) presented severe disability, 58 (40%) moderate disability, and 40 (28%) good recovery. Most frequent somatic problems were fatigue, headaches, other pain, and balance. One quarter of subjects had motor impairments. Rates of cognitive complaints ranged from 25 to 68%, the most frequent being memory, irritability, slowness and concentration. With the Hospital Anxiety and Depression Scale, 43% had anxiety and 25% depression. Overall, 79% were independent in daily living activities and 40 to 50% needed help for outdoor or organizational activities on the BICRO-39. Most had regular contacts with relatives or close friends but few contacts with colleagues or new acquaintances. Subjects spent little time in productive activities such as working, studying, looking after children or voluntary work. Quality of life on the QOLIBRI scale was associated with disability level (P<0.0001). CONCLUSION: Management of late brain injury needs to focus on cognitive difficulties, particularly social skills, to enhance patient participation in life.
OBJECTIVES: Survivors of severe traumatic brain injury have a great variety of impairments and participation restrictions. Detailed descriptions of their long-term outcome are critical. We aimed to assess brain injury outcome for subjects with traumatic brain injury in terms of the International classification of functioning, disability and health. MATERIALS AND METHODS: Four-year follow-up of an inception cohort of adults with severe traumatic brain injury by using face-to-face interviews with patients and proxies. RESULTS: Among 245 survivors at 4 years, 147 were evaluated (80% male, mean age: 32.5±14.2 years at injury); 46 (32%) presented severe disability, 58 (40%) moderate disability, and 40 (28%) good recovery. Most frequent somatic problems were fatigue, headaches, other pain, and balance. One quarter of subjects had motor impairments. Rates of cognitive complaints ranged from 25 to 68%, the most frequent being memory, irritability, slowness and concentration. With the Hospital Anxiety and Depression Scale, 43% had anxiety and 25% depression. Overall, 79% were independent in daily living activities and 40 to 50% needed help for outdoor or organizational activities on the BICRO-39. Most had regular contacts with relatives or close friends but few contacts with colleagues or new acquaintances. Subjects spent little time in productive activities such as working, studying, looking after children or voluntary work. Quality of life on the QOLIBRI scale was associated with disability level (P<0.0001). CONCLUSION: Management of late brain injury needs to focus on cognitive difficulties, particularly social skills, to enhance patient participation in life.
Authors: Noelle E Carlozzi; Michael A Kallen; Phillip A Ianni; Angelle M Sander; Elizabeth A Hahn; Rael T Lange; Tracey A Brickell; Louis M French; Jennifer A Miner; Robin Hanks Journal: Arch Phys Med Rehabil Date: 2018-06-26 Impact factor: 3.966
Authors: Adrian M Svingos; Steven A Robicsek; Ronald L Hayes; Kevin K Wang; Claudia S Robertson; Gretchen M Brophy; Linda Papa; Andrea Gabrielli; H Julia Hannay; Russell M Bauer; Shelley C Heaton Journal: Neurocrit Care Date: 2022-03-01 Impact factor: 3.532
Authors: Noelle E Carlozzi; Robin Hanks; Rael T Lange; Tracey A Brickell; Phillip A Ianni; Jennifer A Miner; Louis M French; Michael A Kallen; Angelle M Sander Journal: Arch Phys Med Rehabil Date: 2018-06-19 Impact factor: 3.966
Authors: Noelle E Carlozzi; Rael T Lange; Louis M French; Angelle M Sander; Phillip A Ianni; David S Tulsky; Jennifer A Miner; Michael A Kallen; Tracey A Brickell Journal: Arch Phys Med Rehabil Date: 2018-06-30 Impact factor: 3.966