Neurologic Functional and Quality of Life Outcomes after TBI: Clinic Attendees Versus Non-Attendees.
AUTHORS
- PMID: 25683481 [PubMed].
ABSTRACT
This investigation describes the relationship between TBI patient demographics, quality of life outcome, and functional status outcome among clinic attendees and non-attendees. Of adult TBI survivors with intracranial hemorrhage, 63 attended our TBI clinic and 167 did not attend. All were telephone surveyed using the Extended-Glasgow Outcome Scale (GOSE), the Quality of Life after Brain Injury (QOLIBRI) scale, and a post-discharge therapy questionnaire. To determine risk factors for GOSE and QOLIBRI outcomes, we created multivariable regression models employing covariates of age, injury characteristics, clinic attendance, insurance status, post-discharge rehabilitation, and time from injury. Compared to those with severe TBI, higher GOSE scores were identified in individuals with both mild (OR=2.0, 95%CI:1.1-3.6) and moderate (OR=4.7, 95%CI:1.6-14.1) TBIs. In addition, survivors with private insurance had higher GOSE scores as compared to those with public insurance (OR=2.0, 95%CI:1.1-3.6), workers’ compensation (OR=8.4, 95%CI:2.6-26.9), and no insurance (OR=3.1, 95%CI:1.6-6.2). Compared to those with severe TBI, QOLIBRI scores were 11.7 points (95%CI:3.7-19.7) higher in survivors with mild TBI and 17.3 points (95%CI:3.2-31.5) higher in survivors with moderate TBI. In addition, survivors who received post-discharge rehabilitation had higher QOLIBRI scores by 11.4 points (95%CI:3.7-19.1) than those who did not. Survivors with private insurance had QOLIBRI scores that were 25.5 points (95%CI:11.3-39.7) higher than those with workers’ compensation and 16.8 points (95%CI:7.4-26.2) higher than those without insurance. Because neurologic injury severity, insurance status, and receipt of rehabilitation or therapy are independent risk factors for functional and quality of life outcomes, future directions will include improving earlier access to post-TBI rehabilitation, social work services, affordable insurance, and community resources.
This investigation describes the relationship between TBI patient demographics, quality of life outcome, and functional status outcome among clinic attendees and non-attendees. Of adult TBI survivors with intracranial hemorrhage, 63 attended our TBI clinic and 167 did not attend. All were telephone surveyed using the Extended-Glasgow Outcome Scale (GOSE), the Quality of Life after Brain Injury (QOLIBRI) scale, and a post-discharge therapy questionnaire. To determine risk factors for GOSE and QOLIBRI outcomes, we created multivariable regression models employing covariates of age, injury characteristics, clinic attendance, insurance status, post-discharge rehabilitation, and time from injury. Compared to those with severe TBI, higher GOSE scores were identified in individuals with both mild (OR=2.0, 95%CI:1.1-3.6) and moderate (OR=4.7, 95%CI:1.6-14.1) TBIs. In addition, survivors with private insurance had higher GOSE scores as compared to those with public insurance (OR=2.0, 95%CI:1.1-3.6), workers’ compensation (OR=8.4, 95%CI:2.6-26.9), and no insurance (OR=3.1, 95%CI:1.6-6.2). Compared to those with severe TBI, QOLIBRI scores were 11.7 points (95%CI:3.7-19.7) higher in survivors with mild TBI and 17.3 points (95%CI:3.2-31.5) higher in survivors with moderate TBI. In addition, survivors who received post-discharge rehabilitation had higher QOLIBRI scores by 11.4 points (95%CI:3.7-19.1) than those who did not. Survivors with private insurance had QOLIBRI scores that were 25.5 points (95%CI:11.3-39.7) higher than those with workers’ compensation and 16.8 points (95%CI:7.4-26.2) higher than those without insurance. Because neurologic injury severity, insurance status, and receipt of rehabilitation or therapy are independent risk factors for functional and quality of life outcomes, future directions will include improving earlier access to post-TBI rehabilitation, social work services, affordable insurance, and community resources.
Tags: Alumni Publications 2015