Long-term outcome of medically confirmed and self-reported early traumatic brain injury in two nationwide samples

Abstract

Primary objectives: To assess long-term effects of early traumatic brain injury (TBI) on mental health, cognition, behaviour and adjustment and to identify prognostic factors.

Methods and procedures: A 1-year nationwide cohort of all 0–19 year old Icelandic children and adolescents diagnosed with TBI in 1992–1993 (n = 550) received a questionnaire with clinical outcome scales and questions on TBI and socio-economic status (SES) by mail ∼16 years post-injury. A control group (n = 1232), newly selected from the National Registry, received the same questionnaire. Non-respondents answered a shorter version by telephone. Overall participation was 67%.

Main outcomes and results: Medically confirmed and self-reported TBI was reflected in worse outcome. Force of impact, number and severity of TBIs predicted poorer results. Parental SES and demographic factors had limited effects. Not reporting early, medically confirmed TBI did not exclude cognitive sequelae. In self-reported disability, absence of evaluation for compensation was not linked to outcome.

Conclusions: Clinical outcome was consistent with late complaints attributed to early TBI. TBI-related variables had greater prognostic value than other factors. Self-reporting of TBI sustained very early in life needs supplementary information from parents and medical records. More consistency in compensation evaluations following paediatric TBI is indicated.

• Adolescents
• children
• longitudinal
• nationwide
• outcome
• prognosis
• traumatic brain injury
• young adults

Acknowledgements

The authors thank all participants for their interest in taking part in the study. The authors are grateful for information and assistance provided by Statistics Iceland, the Icelandic Directorate of Health, Landspitali University Hospital and other state hospitals, emergency departments and healthcare centres.