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Table 2.4 Long-Term Outcomes at Greater than Five Years Post Injury

Author

Year

Country

Sample Size

Study Summary

Moderate to Severe ABI

Grauwmeijer et al.

(2018)

The Netherlands

N=119

Population: 50 individuals with moderate-severe TBI.

Follow-up: 10yr post-injury.

Findings: 20% of individuals at the 10yr follow-up showed symptoms of depression on the CES-D. These patients were more often admitted to rehabilitation or nursing homes and had more psychiatric symptoms at initial hospital discharge (p<0.05). Individuals with depressive symptoms demonstrated significantly worse scores in 6/8 SF-36 subdomains as well as on the physical component and mental component summary scores (p=0.001, p=0.008). Patients with depressive symptoms reported more subjective cognitive complaints with the CFQ; however, they did not perform any worse on neuropsychological tests – except for the d2 test – than those without symptoms.

Andersson et al.

(2017)

Sweden

N=95

 

Population: 95 individuals with TBI, GCS ≤8

Follow-up: 1yr and 10-15yr post injury

Findings: There was no significant difference in GOS scores from 1yr and 10-15yr post ABI. Poorer GOS scores were correlated to age at both 1yr (p<0.001), and 10-15yr (p=0.021). At 10-15yr follow-up, 70% of patients reported mental fatigue. From first to second follow-up, the TBI group had significantly higher rates of mortality (p<0.001, p<0.001) compared to healthy controls.

 Klonoff et al.

(2001)

USA

N=164

 

Population: 164 patients with ABI (TBI=113).

Follow-up: 11yr.

Findings: At follow-up, 83.5% were productive in some capacity; 46.3% were gainfully employed full-time, 11.6% were in full-time school or school/work, 9.2% were in part-time gainful work or school, and 12.2% worked as volunteers. 16.5% were not productive in any capacity. Additionally, younger age (p=0.009), being male (p=0.025), and higher staff working alliance ratings of patients (p=0.024) and their families (p=0.017) were associated with better vocational/school outcomes.

Severe ABI

Possl et al.

(2001)

Germany

N=43

Population: 43 participants with severe ABI.

Follow-up: 7-8yr.

Findings:  At follow-up, 37% had achieved stable re-employment at pre-injury levels, 16% had achieved stable re-employment with work modifications, 19% continued to have persistent vocational adjustment problems, and 28% opted for retirement.

Johnson

(1998)

UK

N=64

Population: 64 patients with severe head injury.

Follow-up: 10yr or more.

Findings:  At follow-up, 42% had re-established employment, 20% had an irregular pattern of work, and the remainder were not in the workforce.

Wilson

(1992)

UK

N=25

 

Population: 25 patients.

Follow-up: 5-10yr.

Findings: At follow-up, 81% were living in their own homes either alone, with relatives, or with friends. Those remaining were in long-term residential care, residential college, or warden controlled accommodation. 42% were in paid employment; 1 of 11 were in paid employment that was comparable to their pre-injury status.