Predictors of informal care burden 1 year after a severe traumatic brain injury: results from the PariS-TBI study.
OBJECTIVE
To investigate predictors of informal care burden 1 year after a severe traumatic brain injury (TBI).


METHODS
Patients (N = 66) aged 15 years or older with severe TBI (Glasgow Coma Scale score of 8 or less) and their primary informal caregivers.


METHODS
Multicenter inception cohort study over 22 months in Paris and the surrounding area (PariS-TBI study).


METHODS
Patients' preinjury characteristics; injury severity data; outcome measures at discharge from intensive care and 1 year after the injury; Dysexecutive Questionnaire; Medical Outcome Study Short Form-36; Zarit Burden Inventory.


RESULTS
Among the 257 survivors at discharge from acute care, 66 patient-caregiver couples were included. Primary informal caregivers were predominantly women (73%), of middle age (age, 50 years), supporting male patients (79%), of mean age of 38 years. The majority (56%) of caregivers experienced significant burden, and 44% were at risk of depression. Caregivers' impaired health status and perceived burden significantly correlated with patients' global disability (as assessed with the Glasgow Outcome Scale-Extended) and impairments of executive functions (as assessed with the Dysexecutive Questionnaire). A focused principal component analysis suggested that disability and executive dysfunctions were independent predictors of perceived burden, whereas demographics, injury severity, and Glasgow Outcome Scale at discharge from acute care did not significantly correlate with caregiver's burden.


CONCLUSIONS
Global handicap and impairments of executive functions are independent significant predictors of caregiver burden 1 year after TBI.
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Physique et Réadaptation, Paris, France (Drs Bayen and Pradat-Diehl); Université Paris-Dauphine, Laboratoire d'Economie et de Gestion des Organisations de Santé (LEDa-LEGOS), Paris, France (Drs Bayen and Joël); Université Pierre et Marie Curie, UFR de médecine, Paris, France (Drs Bayen and Pradat-Diehl); Université Pierre et Marie Curie, Unité ER 6, Paris, France (Drs Pradat-Diehl, Jourdan and Azouvi); AP-HP, Hôpital R. Poincaré, Service de Médecine Physique et Réadaptation, Garches, France (Drs Jourdan and Azouvi); Université de Versailles St-Quentin, UFR de médecine, EA 4497, Guyancourt, France (Drs Jourdan and Azouvi); AP-HP, Hôpital A Paré, Unité de Recherche Clinique Paris-Ouest, Boulogne-Billancourt, France (Mr Ghout, Ms Bosserelle, Ms Azerad, and Dr Aegerter); Centre Ressources Francilien du Traumatisme Crânien, Paris, France (Ms Bosserelle, Ms Azerad, and Dr Weiss); and Université de Versailles St-Quentin, UPRES EA 2506, Guyancourt, France (Dr Aegerter).
Eleonore
E
Bayen
Pascale
P
Pradat-Diehl
Claire
C
Jourdan
Idir
I
Ghout
Vanessa
V
Bosserelle
Sylvie
S
Azerad
Jean-Jacques
JJ
Weiss
Marie-Eve
ME
Joël
Philippe
P
Aegerter
Philippe
P
Azouvi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D017281:Cost of Illness; D056344:Executive Function; D005260:Female; D023261:Glasgow Outcome Scale; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D055815:Young Adult