Beseoglu Kerim, Roussaint Nina, Steiger Hans-Jakob, Hänggi Daniel
Department of Neurosurgery, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Br J Neurosurg. 2013 Apr;27(2):202-6. doi: 10.3109/02688697.2012.717984. Epub 2012 Aug 31.
Controversy exists about the influence of intracranial injuries in mild traumatic brain injury (mTBI) on quality of life (QoL). Some patients do not fully recover from mTBI and experience neurocognitive impairment and reduction in quality of life. We evaluated the influence of structural brain damage on QoL and employment status (ES) after mTBI.
In a partially prospective design we evaluated QoL using Short-Form-36 (SF36) and current ES three years after trauma in 36 patients with mTBI in a matched pair design with two groups of 18 patients each with and without structural brain damage.
Both groups showed a reduction in physical (Physical Functioning, Role Physical, Bodily Pain and General Health) and emotional parameters (Vitality, Social Functioning, Role Emotional and Mental Health) without significant difference between both groups (p = 0.305, p = 0.406, p = 0.624, p = 0.720, p = 0.934, p = 0.282, p = 0.811 and p = 0.270 respectively). ES was independent of structural brain damage and an influential factor for QoL.
MTBI specific QoL assessment including focus on ES is necessary to identify patients at risk for impaired recovery. Structural brain injury as seen on CT scan is not useful as a prognostic tool to predict QoL or ES after mTBI.
关于轻度创伤性脑损伤(mTBI)中的颅内损伤对生活质量(QoL)的影响存在争议。一些患者未能从mTBI中完全康复,出现神经认知障碍和生活质量下降。我们评估了mTBI后脑结构损伤对生活质量和就业状况(ES)的影响。
在一项部分前瞻性设计中,我们采用配对设计,将36例mTBI患者分为两组,每组18例,分别有或无脑结构损伤,在创伤后三年使用简短健康调查问卷(SF36)评估生活质量,并评估当前的就业状况。
两组患者的身体(生理功能、身体角色、身体疼痛和总体健康)和情感参数(活力、社会功能、情感角色和心理健康)均有所下降,两组之间无显著差异(分别为p = 0.305、p = 0.406、p = 0.624、p = 0.720、p = 0.934、p = 0.282、p = 0.811和p = 0.270)。就业状况与脑结构损伤无关,是影响生活质量的一个因素。
mTBI特异性生活质量评估,包括关注就业状况,对于识别恢复受损风险的患者是必要的。CT扫描所见的脑结构损伤作为预测mTBI后生活质量或就业状况的预后工具并无用处。