Outcome following traumatic brain injury: a comparison between 2 and 5 years after injury

Abstract

This study examined long-term outcome in traumatically brain-injured individuals following discharge from a comprehensive rehabilitation programme. Of 254 traumatic brain injury (TBI) patients reviewed at 2 years, 103 have been followed up at 5 years using a structured interview format detailing neurological symptoms, mobility, independence in ADL, productivity status, relationship issues, communication and the presence of cognitive, behavioural and emotional changes. Visual difficulties, headache and fatigue were persistent in a significant number of patients. Between 2 and 5 years there was increased independence in personal, domestic and community ADL and the use of transport. Ten more patients had returned to driving. On the other hand there was a slightly higher incidence of cognitive, behavioural and emotional changes reported at 5 years. Thirty-two per cent of those working at 2 years were not employed at 5 years. Many students had also become unemployed. These findings suggest the need for intermittent lifelong intervention following TBI. Systems of rehabilitation need to be adapted to provide this.

Factors associated with remission of post-traumatic brain injury fatigue in the years following traumatic brain injury (TBI): a TBI model systems module study

“…Van der Naalt and colleagues (1999) noted that at 1 month post injury, 57% of the sample reported fatigue, dropping to 45% at 6 months and one year [1]. Another study reported that 73% of individuals continue to experience fatigue as a chronic problem 5 years post-injury [3].…”

“…In fact, studies have shown that the presence of PTBIF may prevent return to work [9]. PTBIF has not been found to be associated with age or injury severity [3,10].…”

Role of premorbid factors in predicting safe return to driving after severe TBI

“…The variability of the period taken into consideration could perhaps explain why some authors reported time since injury as an important predictor [21] and other authors did not [17,19]. In TBI patients, the functional recovery is typically slow and occurs during the whole year after brain injury and sometimes beyond [75][76][77][78]. Consequently, results of studies adopting a 3-or 6-month follow-up do not generalize to the majority of TBI patients.…”

Predictors of positive growth after traumatic brain injury: A longitudinal study

“…Even those deemed to have made a good recovery often have residual psychological or emotional deficits which prevent them from returning to pre-injury levels of functioning [6][7][8]. However, several researchers suggest that good long-term adjustment after brain injury is achievable, even after severe TBI [9][10][11].…”