The trajectories of overall disability in the first 5 years after moderate and severe traumatic brain injury.

PRIMARY OBJECTIVES

To assess longitudinal trajectories of overall disability after moderate-to-severe traumatic brain injury (TBI) and to examine whether those trajectories could be predicted by socio-demographic and injury characteristics.

METHODS

Demographics and injury characteristics of 105 individuals with moderate-to-severe TBI were extracted from medical records. At the 1-, 2-, and 5-year follow-ups, TBI-related disability was assessed by the GOSE. A hierarchical linear model (HLM) was used to examine functional outcomes up to 5 years following injury and whether those outcomes could be predicted by: time, gender, age, relationship, education, employment pre-injury, occupation, GCS, cause of injury, length of post-traumatic amnesia (PTA), CT findings and injury severity score, as well as the interactions between each of these predictors and time.

RESULTS

Higher GOSE trajectories (lower disability) were predicted by younger age at injury and shorter PTA, as well as by the interaction terms of timePTA and timeemployment. Those who had been employed at injury decreased in disability over time, while those who had been unemployed increased in disability.

CONCLUSION

The study results support the view that individual factors generally outweigh injury-related factors as predictors of disability after TBI, except for PTA.