Katrin Rauen1,2,3, Lara Reichelt4,5, Philipp Probst6, Barbara Schäpers4, Friedemann Müller4, Klaus Jahn4,7, Nikolaus Plesnila5,8. 1. Schoen Clinic Bad Aibling, Kolbermoorer Strasse 72, 83043, Bad Aibling, Germany. Katrin.rauen@uzh.ch. 2. Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Feodor-Lynen-Straße 17, 81377, Munich, Germany. Katrin.rauen@uzh.ch. 3. Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich & Institute for Regenerative Medicine (IREM), University of Zurich, Minervastrasse 145, 8032, Zurich, Switzerland. Katrin.rauen@uzh.ch. 4. Schoen Clinic Bad Aibling, Kolbermoorer Strasse 72, 83043, Bad Aibling, Germany. 5. Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Feodor-Lynen-Straße 17, 81377, Munich, Germany. 6. Institute for Medical Informatics, Biometry and Epidemiology (IBE), University of Munich, Munich, Germany. 7. German Center for Vertigo and Balance Disorders, University of Munich Medical Center, Munich, Germany. 8. Munich Cluster for Systems Neurology (Synergy), Munich, Germany.
Abstract
BACKGROUND: Traumatic brain injury (TBI) is the leading cause of death and disability among children and young adults in industrialized countries, but strikingly little is known how patients cope with the long-term consequences of TBI. Thus, the aim of the current study was to elucidate health-related quality of life (HRQoL) and outcome predictors in chronic TBI adults. METHODS: In this cross-sectional study, 439 former patients were invited to report HRQoL up to 10 years after mild, moderate or severe TBI using the QOLIBRI (Quality of Life after Brain Injury) questionnaire. The QOLIBRI total score has a maximum score of 100. A score below 60 indicates an unfavorable outcome with an increased risk of an affective and/or anxiety disorder. Results were correlated with demographics and basic characteristics received from medical records (TBI severity, etiology, age at TBI, age at survey, time elapsed since TBI, and sex) using regression models. Differences were considered significant at p < 0.05. RESULTS: From the 439 invited patients, 135 out of 150 in principle eligible patients (90%) completed the questionnaire; 76% were male, and most patients experienced severe TBI due to a traffic-related accident (49%) or a fall (44%). The mean QOLIBRI total score was 65.5 (± 22.6), indicating good HRQoL. Factors for higher level of satisfaction (p = 0.03; adjusted R2 = 0.1) were autonomy in daily life (p = 0.03; adjusted R2 = 0.09) and cognition (p = 0.05; adjusted R2 = 0.05). HRQoL was weakly correlated with initial TBI severity (p = 0.04; adjusted R2 = 0.02). 36% of patients reported unfavorable HRQoL with increased risk of one (20%) or two (16%) psychiatric disorders. CONCLUSIONS: The majority of chronic TBI patients reported good HRQoL and the initial TBI severity is a slight contributor but not a strong predictor of HRQoL. Autonomy and cognition are decisive factors for satisfied outcome and should be clearly addressed in neurorehabilitation. One third of patients, however, suffer from unsatisfactory outcome with psychiatric sequelae. Thus, an early neuropsychiatric assessment after TBI is necessary and need to be installed in future TBI guidelines.
BACKGROUND:Traumatic brain injury (TBI) is the leading cause of death and disability among children and young adults in industrialized countries, but strikingly little is known how patients cope with the long-term consequences of TBI. Thus, the aim of the current study was to elucidate health-related quality of life (HRQoL) and outcome predictors in chronic TBI adults. METHODS: In this cross-sectional study, 439 former patients were invited to report HRQoL up to 10 years after mild, moderate or severe TBI using the QOLIBRI (Quality of Life after Brain Injury) questionnaire. The QOLIBRI total score has a maximum score of 100. A score below 60 indicates an unfavorable outcome with an increased risk of an affective and/or anxiety disorder. Results were correlated with demographics and basic characteristics received from medical records (TBI severity, etiology, age at TBI, age at survey, time elapsed since TBI, and sex) using regression models. Differences were considered significant at p < 0.05. RESULTS: From the 439 invited patients, 135 out of 150 in principle eligible patients (90%) completed the questionnaire; 76% were male, and most patients experienced severe TBI due to a traffic-related accident (49%) or a fall (44%). The mean QOLIBRI total score was 65.5 (± 22.6), indicating good HRQoL. Factors for higher level of satisfaction (p = 0.03; adjusted R2 = 0.1) were autonomy in daily life (p = 0.03; adjusted R2 = 0.09) and cognition (p = 0.05; adjusted R2 = 0.05). HRQoL was weakly correlated with initial TBI severity (p = 0.04; adjusted R2 = 0.02). 36% of patients reported unfavorable HRQoL with increased risk of one (20%) or two (16%) psychiatric disorders. CONCLUSIONS: The majority of chronic TBI patients reported good HRQoL and the initial TBI severity is a slight contributor but not a strong predictor of HRQoL. Autonomy and cognition are decisive factors for satisfied outcome and should be clearly addressed in neurorehabilitation. One third of patients, however, suffer from unsatisfactory outcome with psychiatric sequelae. Thus, an early neuropsychiatric assessment after TBI is necessary and need to be installed in future TBI guidelines.
Entities:
Keywords:
Adaptation and resilience; Anxiety; Autonomy and cognition as decisive outcome factors for satisfaction; Depressive disorder; Health-related quality of life after brain injury; Long-term outcome; Psychiatric disorders after brain injury; QOLIBRI; TBI guidelines; Traumatic brain injury
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Authors: Nicole von Steinbuechel; Katrin Rauen; Fabian Bockhop; Amra Covic; Ugne Krenz; Anne Marie Plass; Katrin Cunitz; Suzanne Polinder; Lindsay Wilson; Ewout W Steyerberg; Andrew I R Maas; David Menon; Yi-Jhen Wu; Marina Zeldovich Journal: J Clin Med Date: 2021-05-28 Impact factor: 4.241
Authors: Katrin Rauen; Claudia B Späni; Maria Carmela Tartaglia; Maria Teresa Ferretti; Lara Reichelt; Philipp Probst; Barbara Schäpers; Friedemann Müller; Klaus Jahn; Nikolaus Plesnila Journal: Geroscience Date: 2020-10-17 Impact factor: 7.713