Citation

Grauwmeijer E, Heijenbrok-Kal MH, Ribbers G. Arch. Phys. Med. Rehabil. 2014; 95(7): 1268-1276.

Affiliation

Rijndam Rehabilitation Center, Rotterdam, the Netherlands; Department of Rehabilitation Medicine Erasmus University Medical Center, Rotterdam, the Netherlands.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.02.002

PMID

24561059

Abstract

OBJECTIVES: To evaluate the time course of health-related quality of life (HRQoL) after moderate-to-severe traumatic brain injury (TBI) and to identify its predictors. DESIGN: Prospective cohort study with follow-up measurements at 3, 6, 12, 18, 24, and 36 months after TBI. SETTING: Patients with moderate-to-severe TBI discharged from three level-1 trauma centers. PARTICIPANTS: A total of 97 patients (72% men) aged 32.8 (SD 13.0; range 18-65) years, hospitalized with moderate (23%) or severe (77%) TBI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: HRQoL was measured with the Short Form-36 (SF-36), functional outcomes with the Glasgow Outcome Scale (GOS), Barthel Index, Functional Independence Measure (FIM) and Functional Assessment Measure (FAM), and mood with the Wimbledon Self-Report Scale. RESULTS: The SF-36 domains showed significant improvement over time for Physical Functioning (p<0.001), Role Physical (p<0.001), Bodily Pain (p=0.0004), Social Functioning (p<0.001) and Role Emotional (p=0.024), but not for General Health (p=0.263), Vitality (p=0.530), and Mental Health (p=0.138). Over time there was significant improvement in the Physical Component Summary (PCS) score, whereas the Mental Component Summary (MCS) score remained stable. At 3-year follow-up, HRQoL of TBI patients was the same as that in the Dutch normative population. Time after TBI, length of hospital stay (LOS), FIM and GOS were independent predictors of the PCS, whereas LOS and mood were predictors of the MCS. CONCLUSIONS: After TBI, the physical component of HRQoL showed significant improvement over time whereas the mental component remained stable. Problems of disease awareness seem to play a role in self-reported mental HRQoL. After TBI, mood status is a better predictor of the mental component of HRQoL than functional outcome, implying that mood should be closely monitored during and after rehabilitation.

Language: en