Health-related quality of life in patients with multiple injuries and traumatic brain injury 10+ years postinjury.
BACKGROUND
The aim of this study was to examine the long-term physical and psychological consequences of multiple blunt forced trauma at ≥ 10-year follow-up for patients with and without traumatic brain injury (TBI).


METHODS
A total of 620 patients with multiple injuries were assessed with the Medical Outcomes Study-Short Form-12 and a physical reexamination at ≥ 10-year follow-up. Injury-related characteristics were collected from patients' medical record. Chi-square analysis, Analysis of Variance, and linear and logistic regression were performed to test differences between groups and examine predictors of physical and psychological functioning at ≥ 10-year follow-up.


RESULTS
Patients with multiple injuries who sustained a TBI (n = 398) were more likely to be female (p = 0.001), younger in age at the time of injury (p = 0.02), have higher Injury Severity Scores (p = 0.001), shorter ward stays (p = 0.001), and a greater number of upper extremity injuries (p = 0.02) when compared with those without TBI (n = 222). Patients with TBI reported poorer psychological functioning (p = 0.02) and more frequently reported chronic pain (p = 0.01). Patients with TBI used medical aids (p = 0.002) less frequently at follow-up when compared with patients without TBI. Significant predictors of health-related quality of life at ≥ 10-year follow-up included age at the time of injury (physical; p = 0.001), gender (p = 0.05), number of ventilation days (p = 0.02), satisfaction with rehabilitation (p = 0.001), disability caused by the injury (p = 0.001), and use of medical aids (physical p = 0.02).


CONCLUSIONS
Prospective studies are needed with a broader range of measures that may be sensitive to the consequences of TBI. Evidence-based interventions to facilitate physical and psychological rehabilitation, designed to target at risk patients, are warranted.
Steel
Jennifer
J
Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Youssef
Michael
M
Pfeifer
Roman
R
Ramirez
Juliana M
JM
Probst
Christian
C
Sellei
Richard
R
Zelle
Boris A
BA
Sittaro
Nicola-Alexander
NA
Khalifa
Farah
F
Pape
Hans Christoph
HC
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult