Disability, physical health and mental health 1 year after traumatic brain injury

Abstract

Purpose. The purpose of this study was to assess disability and the physical and mental health status 1 year after traumatic brain injury (TBI), using the International Classification of Functioning, Disability and Health (ICF) as a conceptual model for understanding TBI disability.

Methods. A prospective study of 85 patients with moderate-to-severe TBI (aged 16–55 years) due to injury occurring from May 2005 to May 2007 and hospitalised at the Trauma Referral Centre in Eastern Norway were included. The severity of structural brain damage and overall trauma were used as indices of body structure impairments. Activity limitations were measured by the Functional Independence Measure, and participation restrictions were assessed via the Community Integration Questionnaire. Physical and mental health dimensions as reported on the Medical Outcome Survey Short-Form were chosen as outcome measures.

Results. Roughly one quarter of the patients reported disability requiring personal assistance. One Quarter had major problems with social integration, and 42% were not working. Nearly half of the patients reported poor physical health, and 37% reported poor mental health. Regression models, including demographics, impairments, activity limitations and participation restrictions, accounted for 50% of the variance in physical health and 35% of the variance in mental health. More severe impairments, fewer activity limitations and fewer participation restrictions equated to better overall health.

Conclusions. The results demonstrated that a significant proportion of TBI survivors face substantial disability and impaired overall health 1 year after injury. To optimise health and well-being outcomes, clinicians need to ensure that health needs of patients with less severe TBI are identified and treated during the post-acute period.

Keywords:

• Traumatic brain injury
• disability
• SF-36
• ICF
• FIM
• CIQ

Acknowledgements

The authors want to thank all of the subjects for their participation. Special thanks are given to Tone Jerstad (neuroradiologist, Oslo University Hospital, Ulleval) for the CT assessment, Morten Hestnes (Trauma Register, Oslo University Hospital, Ulleval) for the extraction of trauma scores and Nini Hammergren for assistance with patient registrations. This study was supported by grants from the Norwegian Health South-East Authority.