Trajectory of disability and quality-of-life in non-geriatric and geriatric survivors after severe traumatic brain injury

Abstract

<p><i>Objective</i>: The objective was to investigate disability and health-related quality-of-life (HRQoL) 3, 6 and 12 months after traumatic brain injury (TBI) in non-geriatric (≤ 65 years) and geriatric patients (> 65 years).</p> <p><i>Methods</i>: Patients ≥ 16 years who sustained a severe TBI (Abbreviated Injury Scale of the head region > 3) were included in this prospective, multi-centre study. Outcome measures were Glasgow Outcome Scale Extended (GOSE; disability), SF-12 (HRQoL). Mixed linear model analyses were performed.</p> <p><i>Results</i>: Three hundred and fifty-one patients (median age = 50 years; interquartile range (IQR) = 27–67) were included; 73.2% were male and 27.6% were geriatric patients. Median GOSE at 3, 6 and 12 months was 5 (IQR = 3–7), 6 (IQR = 4–8) and 7 (IQR = 5–8); this increase (slope_time = 0.22, <i>p</i> < 0.0001) was age dependent (slope_age*time = –0.06, <i>p</i> = 0.003). Median SF-12 physical component scale score at 3, 6 and 12 months was 42.1 (IQR = 33.6–50.7), 46.6 (IQR = 37.4–53.9) and 50.4 (IQR = 39.2–55.1); this increase (slope_time = 1.52, <i>p <</i> 0.0001) was not age dependent (slope_age*time = –0.30, <i>p</i> = 0.083). SF-12 mental component scale scores were unchanged.</p> <p><i>Conclusions</i>: Disability decreased and HRQoL improved after TBI between 3–12 months. In geriatric patients this improvement was relevant for HRQoL only.</p