Health-related quality of life 12 months after severe traumatic brain injury: a prospective nationwide cohort study.

Abstract

OBJECTIVE: To assess health-related quality of life in individuals with severe traumatic brain injury at 12 months post-injury, applying the Quality of Life after Brain Injury (QOLIBRI) instrument, and to study the relationship between injury-related factors, post-injury functioning and health-related quality of life. DESIGN/SUBJECTS: The study is part of a prospective, Norwegian multicentre study of adults (≥_16 years old) with severe traumatic brain injury, as defined by a Glasgow Coma Scale score of 3-8 during the first 24 h post-injury. A total of 126 patients were included. METHODS: Socio-demographic data and injury severity variables were collected. Functioning at 3 and 12 months was assessed with the Glasgow Outcome Scale Extended (GOSE), the Functional Independence Measure (FIM), the Rivermead Post-concussion Questionnaire (RPQ), and the Hospital Anxiety and Depression Scale (HADS). Hierarchical regression analysis was applied. RESULTS: Mean QOLIBRI score was 68.5 (standard deviation =_18.8). Predictors of the QOLIBRI in the final regression model were: employment status (p_=_0.05), GOSE (p_=_0.05), RPQ (p_<_0.001) and HADS (p_<_0.001). The adjusted R2 showed that the model explained 64.0% of the variance in the QOLIBRI score. CONCLUSION: Symptom pressure and global functioning in the sub-acute phase of traumatic brain injury and psychological distress in the post-acute phase are important for health-related quality of life at 12 months post-injury. These domains should be the focus in rehabilitation aiming to improve health-related quality of life in patients with severe traumatic brain injury.