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Abstract
Objectives: To assess outcome and predicting factors 1 year after a severe traumatic brain injury (TBI).
Methods: Multi-centre prospective inception cohort study of patients aged 15 or older with a severe TBI in the Parisian area, France. Data were collected prospectively starting the day of injury. One-year evaluation included the relatives-rating of the Dysexecutive Questionnaire (DEX-R), the Glasgow Outcome Scale–Extended (GOSE) and employment. Univariate and multivariate tests were computed.
Results: Among 257 survivors, 134 were included (mean age 36 years, 84% men). Good recovery concerned 19%, moderate disability 43% and severe disability 38%. Among patients employed pre-injury, 42% were working, 28% with no job change. DEX-R score was significantly associated with length of education only. Among initial severity measures, only the IMPACT prognostic score was significantly related to GOSE in univariate analyses, while measures relating to early evolution were more significant predictors. In multivariate analyses, independent predictors of GOSE were length of stay in intensive care (LOS), age and education. Independent predictors of employment were LOS and age.
Conclusions: Age, education and injury severity are independent predictors of global disability and return to work 1 year after a severe TBI.
Acknowledgements
The authors thank all patients and family participants who took the time to share their experience and all members of the CRFTC Steering Committee (Centre Ressource Francilien des Traumatisés Crâniens) for their valuable help. The authors also thank Pr Pernot, Dr Dulou, Pr Tadie, Pr Truelle, Dr Welschbillig and Dr Zouaoui for their participation in the study.