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, Konstantin; Amsler, Felix; Groß, Thomas

doi:10.1186/s12955-018-0966-z

Cited by 21 publications

(26 citation statements)

References 52 publications

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“…A head injury is associated with significant early limitations in most aspects of everyday life [49]. However, this phenomenon is also shown in other studies [50,51], in which the disease-specific health-related quality of life revealed no differences one year after a traumatic brain injury. This could be a result of recalibration, reconceptualization and reprioritization of internal standards and references utilized for selfappraisal, also called response shift [52].…”

Section: Discussionmentioning

confidence: 75%

Longitudinal analysis of health status the first year after trauma in severely injured patients

Havermans¹,

Jongh²,

Munter

et al. 2020

Scand J Trauma Resusc Emerg Med

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Purpose: While survival rates after a trauma are increasing a considerable part of the trauma population are still at risk for both short and long term disabilities. Little is known about prognostic factors over time after a severe trauma. The aim of the present prospective cohort study was to examine trauma and patient related prognostic factors for a lower health status over time after a severe trauma. Methods: A multicentre prospective observational cohort study was conducted. Adult trauma patients with severe injuries (ISS ≥ 16) were included from August 2015 until November 2016 if admitted to one of the hospitals in Noord-Brabant (the Netherlands). Outcome measure was health status, measured by the EuroQol-5D (EQ-5D utility and EQ-Visual analogue scale) and the Health Utilities Index (HUI2 and HUI3) one week and one, three, six, and twelve months after injury. Patient and trauma characteristics were analysed as prognostic factors with linear mixed models. The effect of each prognostic factor over time was analysed by adding the interaction term between the prognostic factor and time point in a multivariable linear mixed model, adjusted for confounders. Additionally, the risk factors for problems in the EQ-5 dimensions of HS and cognition were analysed. Results: In total 239 severely injured patients participated. Pre-injury health status, hospital length of stay, ISS and comorbidities were significant prognostic factors for a lower health status. A younger age and extremity injury were prognostic factors for a lower health status until one month after trauma and unemployment before trauma and comorbidities six until twelve months after trauma. In the EQ-5 dimensions 44.1% remained problems in mobility, 15.3% in self-care, 46.4% in activity, 53.3% in pain, 32.5% in anxiety and 35.7% in cognition. Conclusions: Lower pre-injury health status, longer hospital length of stay, higher ISS, and comorbidities were significant prognostic factors for a lower health status during one year after a severe injury. A younger age and an extremity injury were short-term prognostic factors and unemployment before trauma and comorbidities were long-term prognostic factors. Even after twelve months patients in our population reported more problems in all EQ-5D dimensions when compared to the Dutch reference population.

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Section: Discussionmentioning

confidence: 75%

Longitudinal analysis of health status the first year after trauma in severely injured patients

Havermans¹,

Jongh²,

Munter

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…An alternative sensitivity analysis considered a lower utility value of 0.63 (in both treatment groups), based on the midpoint of mild and moderate TBI utility values, as reported in a Swiss quality of life study. 16 This was used to assess the impact of a lower utility estimate on the cost-effectiveness.…”

Section: Utilitymentioning

confidence: 99%

Cost-effectiveness analysis of tranexamic acid for the treatment of traumatic brain injury, based on the results of the CRASH-3 randomised trial: a decision modelling approach

et al. 2020

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IntroductionAn estimated 69 million traumatic brain injuries (TBI) occur each year worldwide, with most in low-income and middle-income countries. The CRASH-3 randomised trial found that intravenous administration of tranexamic acid within 3 hours of injury reduces head injury deaths in patients sustaining a mild or moderate TBI. We examined the cost-effectiveness of tranexamic acid treatment for TBI.MethodsA Markov decision model was developed to assess the cost-effectiveness of treatment with and without tranexamic acid, in addition to current practice. We modelled the decision in the UK and Pakistan from a health service perspective, over a lifetime time horizon. We used data from the CRASH-3 trial for the risk of death during the trial period (28 days) and patient quality of life, and data from the literature to estimate costs and long-term outcomes post-TBI. We present outcomes as quality-adjusted life years (QALYs) and 2018 costs in pounds for the UK, and US dollars for Pakistan. Incremental cost-effectiveness ratios (ICER) per QALY gained were estimated, and compared with country specific cost-effective thresholds. Deterministic and probabilistic sensitivity analyses were also performed.ResultsTranexamic acid was highly cost-effective for patients with mild TBI and intracranial bleeding or patients with moderate TBI, at £4288 per QALY in the UK, and US$24 per QALY in Pakistan. Tranexamic acid was 99% and 98% cost-effective at the cost-effectiveness thresholds for the UK and Pakistan, respectively, and remained cost-effective across all deterministic sensitivity analyses. Tranexamic acid was even more cost-effective with earlier treatment administration. The cost-effectiveness for those with severe TBI was uncertain.ConclusionEarly administration of tranexamic acid is highly cost-effective for patients with mild or moderate TBI in the UK and Pakistan, relative to the cost-effectiveness thresholds used. The estimated ICERs suggest treatment is likely to be cost-effective across all income settings globally.

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“…Additionally, electronic medical records were collected such as the clinical characteristics, treatment, and functional outcomes. After resuscitation, the GCS scores were categorized into mild TBI (GCS score [13][14][15], moderate TBI (GCS score 9-12), and severe TBI (GCS score 3-8). 4 The functional outcome of the present study was assessed using the GOS when the patients were discharged from hospital.…”

Section: Study Designs and Study Populationmentioning

confidence: 99%

“…HRQoL refers to the individual's perception of well-being in the physical, mental, and social domains. 13 The HRQoL is considered as one of the health outcome indicators, and various HRQoL measurement tools have been used to estimate TBI, such as the quality of life after brain injury overall scale (QOLIBRI-OS) 14,15 and the traumatic brain injury caregiver quality of life (TBI-CareQOL). 16 von Steinbuechel et al measured the HRQoL among 795 patients with TBI using QOLIBRI-OS and found that the extended Glasgow outcome scale (GOS-E) was associated with HRQoL, 14 while Born et al used this questionnaire and reported that severe head injury and injured extremities were associated with a poorer HRQoL.…”

mentioning

confidence: 99%

Predicting the Health-related Quality of Life in Patients Following Traumatic Brain Injury

et al. 2021

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Background Traumatic brain injury (TBI) commonly causes death and disability that can result in productivity loss and economic burden. The health-related quality of life (HRQoL) has been measured in patients suffering from TBI, both in clinical and socioeconomic perspectives. The study aimed to assess the HRQoL in patients following TBI using the European quality of life measure-5 domain-5 level (EQ-5D-5L) questionnaire and develop models for predicting the EQ-5D-5L index score in patients with TBI. Method A cross-sectional study was performed with 193 TBI patients who had completed the EQ-5D-5L questionnaire. The clinical characteristics, Glasgow coma scale (GCS) score, treatment, and Glasgow outcome scale (GOS) were collected. The total data was divided into training data (80%) and testing data (20%); hence, the factors affecting the EQ-5D-5L index scores were used to develop the predictive model with linear and nonlinear regression. The performances of the predictive models were estimated with the adjusted coefficient of determination (R2) and the root mean square error (RMSE). Results A good recovery was found at 96.4%, while 2.1% displayed an unfavorable outcome. Moreover, the mean EQ-5D-5L index scores were 0.91558 (standard deviation [SD] 1.09639). GCS score, pupillary light reflex, surgery, and GOS score significantly correlated with the HRQoL scores. The multiple linear regression model had a high adjusted R2 of 0.6971 and a low RMSE of 0.06701, while the polynomial regression developed a nonlinear model that had the highest adjusted R2 of 0.6843 and the lowest RMSE of 0.06748. Conclusions A strong positive correlation between the physician-based outcome as GOS and HRQoL was observed. Furthermore, both the linear and nonlinear regression models were acceptable approaches to predict the HRQoL of patients after TBI. There would be limitations for estimating the HRQoL in unconscious or intubated patients. The HRQoL obtained from the predictive models would be an alternative method to resolve this problem.

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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

Cited by 21 publications

References 52 publications

Longitudinal analysis of health status the first year after trauma in severely injured patients

Longitudinal analysis of health status the first year after trauma in severely injured patients

Cost-effectiveness analysis of tranexamic acid for the treatment of traumatic brain injury, based on the results of the CRASH-3 randomised trial: a decision modelling approach

Predicting the Health-related Quality of Life in Patients Following Traumatic Brain Injury

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