Thomas Jackson Humphries1,2, Saurabh Sinha3, Jeremy Dawson4, Fiona Lecky4, Rajiv Singh4,5. 1. University of Sheffield, Sheffield, UK. thomas.j.humphries@doctors.org.uk. 2. Sheffield Institute of Translational Neuroscience (Sitran), University of Sheffield, Sheffield, UK. thomas.j.humphries@doctors.org.uk. 3. Department of Neurosurgery, Sheffield Teaching Hospitals, Sheffield, UK. 4. Health Services Research, School of Health and Related Research (Scharr), Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK. 5. Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine, Sheffield Teaching Hospitals, Sheffield, UK.
Abstract
OBJECTIVES: To identify risk factors for poor outcome one year post-mild traumatic brain injury (mTBI). DESIGN: This study was a prospective observational study using consecutive adult hospital admissions with mTBI. SUBJECTS: A total of 869 consecutive mTBI patients were enrolled in this study. METHODS: All patients were reviewed by the specialist TBI rehabilitation team at six weeks and one year following mTBI. Demographic and injury data collected included: age, gender, TBI severity and Glasgow Coma Scale (GCS). At twelve months, global outcome was assessed by the Extended Glasgow Outcome Score (GOSE) and participation restriction by the Rivermead Head Injury Follow-up Questionnaire (RHFUQ) via semi-structured interview. An ordinal regression (OR) was used to identify associated factors for poor GOSE outcome and a linear regression for a poor RHFUQ outcome. RESULTS: In the GOSE analysis, lower GCS (p < 0.001), medical comorbidity (p = 0.027), depression (p < 0.001) and male gender (p = 0.008) were identified as risk factors for poor outcome. The RHFUQ analysis identified: lower GCS (p = 0.002), female gender (p = 0.001) and injuries from assault (p = 0.003) were variables associated with worse social functioning at one year. CONCLUSION: mTBI is associated with a significant impact upon the physical health and psychosocial function of affected individuals. The results of this study demonstrate that differences in mTBI outcome can be identified at twelve months post-mTBI and that certain features, particularly GCS, are associated with poorer outcomes.
OBJECTIVES: To identify risk factors for poor outcome one year post-mild traumatic brain injury (mTBI). DESIGN: This study was a prospective observational study using consecutive adult hospital admissions with mTBI. SUBJECTS: A total of 869 consecutive mTBI patients were enrolled in this study. METHODS: All patients were reviewed by the specialist TBI rehabilitation team at six weeks and one year following mTBI. Demographic and injury data collected included: age, gender, TBI severity and Glasgow Coma Scale (GCS). At twelve months, global outcome was assessed by the Extended Glasgow Outcome Score (GOSE) and participation restriction by the Rivermead Head Injury Follow-up Questionnaire (RHFUQ) via semi-structured interview. An ordinal regression (OR) was used to identify associated factors for poor GOSE outcome and a linear regression for a poor RHFUQ outcome. RESULTS: In the GOSE analysis, lower GCS (p < 0.001), medical comorbidity (p = 0.027), depression (p < 0.001) and male gender (p = 0.008) were identified as risk factors for poor outcome. The RHFUQ analysis identified: lower GCS (p = 0.002), female gender (p = 0.001) and injuries from assault (p = 0.003) were variables associated with worse social functioning at one year. CONCLUSION: mTBI is associated with a significant impact upon the physical health and psychosocial function of affected individuals. The results of this study demonstrate that differences in mTBI outcome can be identified at twelve months post-mTBI and that certain features, particularly GCS, are associated with poorer outcomes.
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