Interpreting Quality of Life after Brain Injury Scores: Cross-Walk with the Short Form-36

Wilson, Lindsay; Marsden-Loftus, Isaac; Koskinen, Sanna; Bakx, Wilbert; Bullinger, Monika; Formisano, Rita; Maas, Andrew I.R.; Neugebauer, E.; Powell, J. Enoch; Sarajuuri, Jaana; Sasse, Nadine; Steinbüechel, Nicole von; Wild, K. von; Truelle, Jean-Luc

doi:10.1089/neu.2015.4287

Cited by 54 publications

(60 citation statements)

References 18 publications

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“…Our cohort of patients had higher average PCS scores (M = 52.46, SD ± 19.46) compared to MCS (M = 51.77, SD ± 25.60). This is in agreement with results of the study by Steinbuechel et al, Hawthorne et al and Wilson et al [ 20 , 36 , 41 ]. In contrast, other studies found reverse results with subjects having higher MCS than PCS [ 15 , 17 , 21 , 34 ].…”

Section: Discussionsupporting

confidence: 94%

Spectrum of outcomes following traumatic brain injury—relationship between functional impairment and health-related quality of life

et al. 2017

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BackgroundThe outcome following traumatic brain injury (TBI) is heterogeneous and poorly defined and physical disability scales like the extended Glasgow Outcome Score (GOSE) while providing valuation information in terms of broad categorisation of outcome are unlikely to capture the full spectrum of deficits. Quality of life questionnaires such as SF-36 are emerging as potential tools to help characterise factors important to patients’ recovery. This study assessed the association between physical disability and subjective health rating. The relationship is of value as it may help evaluate the impact of TBI on patients’ lives and facilitate the delivery of appropriate neuro-rehabilitation services.MethodsA single-centre retrospective study was undertaken to assess the relationship between physical outcome as measured by GOSE and quality of life captured by the SF-36 questionnaire. Cronbach’s alpha was calculated for each of the eight SF-36 domains to measure internal consistency of the test. Multivariate analysis of variance was conducted to look at the association between GOSE and the physical (PCS) and mental (MCS) component scores on the SF-36. Finally, we performed a generalised linear mixed model (GLMM) to assess the relative contribution of GOSE score, age at the time of trauma, sex and TBI duration towards MCS and PCS rating.ResultsThere is a statistically significant difference in the MCS and PCS scores based on patients’ GOSE scores. The mean scores of the eight SF-36 domains showed significant association with GOSE. GLMM demonstrated that GOSE was the strongest predictor of PCS and MCS. Age was an important variable in the PCS score while time following trauma was a significant predictor of MCS rating.ConclusionsThis study highlights that patients’ physical outcome following TBI is a strong predictor of the subjective mental and physical health. Nevertheless, there remains tremendous variability in individual SF-36 scores for each GOSE category, highlighting that additional factors play a role in determining quality of life.

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Section: Discussionsupporting

confidence: 94%

Spectrum of outcomes following traumatic brain injury—relationship between functional impairment and health-related quality of life

et al. 2017

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“…Comparing major TBI with no or mild TBI patients 20.8% ( n = 22) and 18.5% ( n = 17), respectively, presented with a total QOLIBRI of < 60 ( p = 0.690) and were defined as having an impaired HRQoL according to Wilson [ 38 ]. 27.0% ( n = 27) achieved an SF-36 mental (MCS) < 40 ( p = 0.629) and were considered conspicuous.…”

Section: Resultsmentioning

confidence: 99%

Prospective evaluation of the Quality of Life after Brain Injury (QOLIBRI) score: minor differences in patients with major versus no or mild traumatic brain injury at one-year follow up

Born

Amsler²,

Groß

2018

Health Qual Life Outcomes

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BackgroundThe Quality of Life after Brain Injury (QOLIBRI) score was developed to assess disease-specific health-related quality of life (HRQoL) after traumatic brain injury (TBI). So far, validation studies on the QOLIBRI were only conducted in cohorts with traumatic brain injury. This study investigated the longer-term residuals in severely injured patients, focusing specifically on the possible impact of major TBI.MethodsIn a prospective questionnaire investigation, 199 survivors with an injury severity score (ISS) > 15 participated in one-year follow-up. Patients who had sustained major TBI (abbreviated injury scale, AIS head > 2) were compared with patients who had no or only mild TBI (AIS head ≤ 2). Univariate analysis (ANOVA, Cohen’s kappa, Pearson’s r) and stepwise linear regression analysis (B with 95% CI, R, R2) were used.ResultsThe total QOLIBRI revealed no differences in one-year outcomes between patients with versus without major TBI (75 and 76, resp.; p = 0.68). With regard to the cognitive subscore, the group with major TBI demonstrated significantly more limitations than the one with no or mild TBI (p < 0.05). The AIS head correlated significantly with the cognitive dimension of the QOLIBRI (r = − 0.16; p < 0.05), but not with the mental components of the SF-36 or the TOP. In multivariate analysis, the influence of the severity of head injury (AIS head) on total QOLIBRI was weaker than that of injured extremities (R2 = 0.02; p < 0.05 vs. R2 = 0.04; p = 0.001) and equal to the QOLIBRI cognitive subscore (R2 = 0.03, p < 0.01 each).ConclusionsGiven the unexpected result of similar mean QOLIBRI total score values and only minor differences in cognitive deficits following major trauma independently of whether patients sustained major brain injury or not, further studies should investigate whether the QOLIBRI actually has the discriminative capacity to detect specific residuals of major TBI. In effect, the score appears to indicate mental deficits following different types of severe trauma, which should be evaluated in more detail.Trial registrationNCT02165137; retrospectively registered 11 June 2014.

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“…Proxy completion is impossible for many QOLIBRI items and misses the essence of measuring the “self-perceived” HRQoL. It also remains unclear whether the cut-off point of 60 is satisfying for quantifying a good HRQoL [ 49 ]. Therefore, validity should be confirmed for patients with TBI-associated persisting cognitive restraints or suitable new (HRQoL) measurement options need to be developed.…”

Section: Discussionmentioning

confidence: 99%

“…Scores are transformed to total scores ranging from 0 (worst possible quality of life) to 100 (best possible quality of life) [ 46 ]. A score lower than 60 is believed to represent a low or impaired HRQoL [ 49 ]. In case patients did not return the questionnaire, the investigators attempted a telephone interview, or family members were asked to assist in completing the forms.…”

Section: Methodsmentioning

confidence: 99%

Functional and patient-reported outcome versus in-hospital costs after traumatic acute subdural hematoma (t-ASDH): a neurosurgical paradox?

et al. 2019

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Background The decision whether to operate or not in patients with a traumatic acute subdural hematoma (t-ASDH) can, in many cases, be a neurosurgical dilemma. There is a general conception that operating on severe cases leads to the survival of severely disabled patients and is associated with relatively high medical costs. There is however little information on the quality of life of patients after operation for t-ASDH, let alone on the cost-effectiveness. Methods This study retrospectively investigated patient outcome and in-hospital costs for 108 consecutive patients with a t-ASDH. Patient outcome was assessed using the Glasgow Outcome Score (GOS) and the Traumatic Brain Injury (TBI)–specific QOLIBRI questionnaire. The in-hospital costs were calculated using the Dutch guidelines for costs calculation. Results Out of 108 patients, 40 were classified as having sustained a mild (Glasgow Coma Scale (GCS) 13–15), 19 a moderate (GCS 9–12), and 49 a severe (GCS 3–8) TBI. As expected, mortality rates increased with higher TBI severity (23%, 47%, and 61% respectively), whereas the chance for favorable outcome (GOS 4–5) decreased (72%, 47%, and 29%). Interestingly, the mean QOLIBRI scores for survivors were quite similar between the TBI severity groups (61, 61, and 64). Healthcare consumption and in-hospital costs increased with TBI severity. In-hospital costs were relatively high (€24,980), especially after emergency surgery (€28,670) and when additional ICP monitoring was used (€36,580). Conclusions Although this study confirms that outcome is often “unfavorable” after t-ASDH, it also shows that “favorable” outcome can be achieved, even in the most severely injured patients. In-hospital treatment costs were substantial and mainly related to TBI severity, with admission and surgery as main cost drivers. These results serve as a basis for necessary future research focusing on the value-based cost-effectiveness of surgical treatment of patients with a t-ASDH. Electronic supplementary material The online version of this article (10.1007/s00701-019-03878-5) contains supplementary material, which is available to authorized users.

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Interpreting Quality of Life after Brain Injury Scores: Cross-Walk with the Short Form-36

Cited by 54 publications

References 18 publications

Spectrum of outcomes following traumatic brain injury—relationship between functional impairment and health-related quality of life

Spectrum of outcomes following traumatic brain injury—relationship between functional impairment and health-related quality of life

Prospective evaluation of the Quality of Life after Brain Injury (QOLIBRI) score: minor differences in patients with major versus no or mild traumatic brain injury at one-year follow up

Functional and patient-reported outcome versus in-hospital costs after traumatic acute subdural hematoma (t-ASDH): a neurosurgical paradox?

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