Citation

Singh R, Choudhri K, Sinha S, Mason S, Lecky F, Dawson J. Clin. Neurol. Neurosurg. 2019; 186: e105526.

Affiliation

Institute of Work Psychology, Sheffield University Management School, Conduit Road, Sheffield, S10 1FL, UK.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.clineuro.2019.105526

PMID

31585337

Abstract

OBJECTIVES: Traumatic Brain Injury(TBI) is one of the most common neurosurgical emergencies but the long-term outcome remains unclear. This study investigated the global outcome and return to work after TBI and tried to identify any relationships that exist with injury and demographic features. PATIENTS & METHODS: 1322 consecutive TBI admissions over 4 years, assessed at a specialist neurorehabilitation clinic at 10weeks and 1 yr. The outcomes were Extended Glasgow Outcome Scale(GOSE), return to work, Rivermead Head Injury Follow-up Questionnaire, Rivermead Post-Concussion Symptoms and the Hospital Anxiety and Depression Score.

RESULTS: 1 year follow-up was achieved in 1207(91.3%). Mean age was 46.9(SD17.3) and 49.2% had mild TBI. The proportion attaining Good Recovery increased from 25.1% to 42.9% by 1 year. However 11.4% deteriorated in GOSE. Only 28.1% of individuals returned to the same pre-morbid level of work by 10 weeks, improving to 45.9% at 1 year. Over a quarter (25.6%) at 1 year were unable to make any return to work or study. Several demographic and injury variables were associated with these outcomes including TBI severity, social class, past psychiatric history and alcohol intoxication. These may allow targeting of vulnerable individuals.

CONCLUSIONS: In a largely representative TBI population including predominantly mild injury, there is still considerable functional disability at 1 year and many individuals are unable to make any return to pre-morbid vocation.

Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.

Language: en

Keywords

Cohort; Employment; Follow-up; GOSE; ICF; Outcome; Participation restriction; Prognosis; TBI