Quality of life and psychological health after mild traumatic brain injury in older people: Three- and six-month follow up

Hume, Camilla H; Mitra, Biswadev; Wright, Bradley J.; Kinsella, Glynda

doi:10.1080/02699052.2023.2237882

Cited by 3 publications

(3 citation statements)

References 52 publications

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“…Fourth, since this study was part of the UPFRONT study, a separate sample size calculation was not conducted for the HRQoL questionnaire and its subdomains. However, when considering other studies examining older adults and HRQoL, our group is comparable or even larger [38,54,55]. Therefore, we believe that our sample size was sufficient to provide a reliable assessment of HRQoL, although we might have lacked power for detecting differences at the subdomain level.…”

Section: Discussionmentioning

confidence: 94%

“…One study showed that young adults (aged 18-35 years) were especially at risk of a poorer quality of life six months after sustaining mTBI [37]. A recent study reported lower HRQoL up to six months post-injury in older mTBI patients compared to non-injured older adults [38]. This last study seems to contradict our current results, which could be due to the fact that their study involved a relatively small population with 92% of the elderly patients reporting their HRQoL to be normal.…”

Section: Discussionmentioning

confidence: 99%

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Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

Coffeng,

Abdulle,

van der Horn

et al. 2024

JCM

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Background: Older adults (OAs) with mild traumatic brain injury (OA-mTBI) are a growing population, but studies on long-term outcomes and quality of life are scarce. Our aim was to determine the health-related quality of life (HRQoL) in OA-mTBI one year after injury and to assess the early predictors of HRQoL. Methods: Data from a prospective follow-up study of 164 older (≥60 years) and 289 younger mTBI patients (<60 years) admitted to the emergency department were analyzed. Post-traumatic complaints, emotional distress and coping were evaluated 2 weeks post-injury using standardized questionnaires. At 12 months post-injury, HRQoL and functional recovery were determined with the abbreviated version of the World Health Organization Quality of Life scale and Glasgow Outcome Scale Extended (GOSE), respectively. Results: One year post-injury, 80% (n = 131) of the OA-mTBI rated their HRQoL as “good” or “very good”, which was comparable to younger patients (79% (n = 226), p = 0.72). Incomplete recovery (GOSE <8) was present in 43% (n = 69) of OA-mTBI, with 67% (n = 46) reporting good HRQoL. Two weeks post-injury, fewer OA-mTBI had (≥2) post-traumatic complaints compared to younger patients (68% vs. 80%, p = 0.01). In the multivariable analyses, only depression-related symptoms (OR = 1.20 for each symptom, 95% CI = 1.01–1.34, p < 0.01) were predictors of poor HRQoL in OA-mTBI. Conclusions: Similar to younger patients, most OA-mTBI rated their HRQoL as good at one year after injury, although a considerable proportion showed incomplete recovery according to the GOSE, suggesting a disability paradox. Depression-related symptoms emerged as a significant predictor for poor HRQoL and can be identified as an early target for treatment after mTBI.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

Coffeng,

Abdulle,

van der Horn

et al. 2024

JCM

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“…HRQOL is a crucial outcome metric for individuals with mTBI. A study found that, in comparison to their contemporaries who were not injured, older persons with mTBI had worse quality of life for up to six months after the injury (Hume et al, 2023). Patients who simultaneously experienced somatic and cognitive postconcussion symptoms (PCS) had a lower HRQOL six months after injury (Voormolen et al, 2019;Yousefzadeh-Chabok, Kapourchali and Ramezani, 2021).…”

Section: Introductionmentioning

confidence: 99%

Early patients' illness perception as a predictor of post-traumatic stress disorder and quality of life one month after mild traumatic brain injury: a prospective study

Mulyadi,

Sithichoksakulchai,

Gannika

et al. 2024

J. Ners

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Introduction: The illness perception of mild Traumatic Brain Injury (mTBI) patients before discharge from the hospital tends to be inappropriate. Apart from that, post-injury symptoms such as post-traumatic stress disorder (PTSD) are often experienced by patients, which can affect their quality of life. However, research linking patient perceptions with post-traumatic stress and quality of life remains scarce. This study aimed to examine patient’s illness perceptions and their relationship with PTSD and HRQOL. Methods: This study employed a prospective survey. Illness perceptions were measured before hospital discharge, and a follow-up of post-traumatic stress and health-related quality of life using an online survey was conducted one month later. The survey was administered from July to October 2023 at two hospitals, with a sample size of 72 mTBI patients. Results: mTBI patients with older age (p=.001), negative emotional perceptions (p=<.001), more consequence (p=.045), more concern about their injury (p=<.001) are significantly related to more symptoms of post-traumatic stress. Patients with mTBI who felt more identity symptoms of IR (p=.001), worsened personal control (p=.041), and worsened treatment control (p=.011) are significantly related to deteriorated quality of life one month after injury. Conclusions: This study produces evidence that mTBI patients' perceptions before leaving the hospital tend to be inappropriate and are related to post-traumatic stress and quality of life one month later. Based on these results, it is crucial for trauma nurses to identify patients' illness perceptions and initiate appropriate interventions to reduce PTSD symptoms and improve patients’ quality of life.

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Survival and predictive factors of clinical outcome in patients with severe acquired brain injury

TYLL,

BUBENÍKOVÁ,

VOTAVA

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND Despite the many tools available to modern medicine, predicting the neurological and functional status of patients after severe brain injury remains difficult. AIM This analysis evaluates the outcomes of patients with the most severe degree of cerebral function impairment. DESIGN Retrospective cohort study. SETTING Patients hospitalized in the long-term Intensive Care Unit (ICU) department in the Military University Hospital in Prague between 2015-2022. POPULATION We analyzed patients with severe acquired brain damage from five distinct etiologies whose initial Glasgow Coma Scale (GCS) score was eight or less upon admission to ICU due to neurological damage. METHODS Several parameters reflecting the patients’ clinical status were evaluated. Overall survival after discharge from the ICU was calculated according to the Kaplan-Meier model with comparison between traumatic (TR) and non-traumatic (non-TR) etiologies. RESULTS The analyzed cohort of 221 patients consisted of 116 patients of TR and 105 of non-TR etiology. There was no significant difference in overall survival between TR and non-TR groups. The length of hospitalization in the ICU was similar in both groups with a median of 94 days. The majority of patients had an improvement of GCS during the hospitalization with a median improvement of five points. GCS improvement occurred in the vast majority of patients regardless of TR or non-TR etiology. CONCLUSIONS We did not observe a statistically significant difference in mortality or log-term neurological status between patients with severe brain injury of traumatic or non-traumatic etiology for the duration of our follow-up. The majority of patients had improved GCS, were successfully decannulated, but remained disabled with severe limitations of functional independence. CLINICAL REHABILITATION IMPACT The return of the patient to normal life is a rehabilitation challenge, regardless of the etiology of brain injury, and is extremely influenced by the level of development of neurorehabilitation programs in individual institutions, the severity of brain injury, and the individual motivation of the patient.

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Quality of life and psychological health after mild traumatic brain injury in older people: Three- and six-month follow up

Cited by 3 publications

References 52 publications

Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

Early patients' illness perception as a predictor of post-traumatic stress disorder and quality of life one month after mild traumatic brain injury: a prospective study

Survival and predictive factors of clinical outcome in patients with severe acquired brain injury

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