Forslund Marit V, Roe Cecilie, Perrin Paul B, Sigurdardottir Solrun, Lu Juan, Berntsen Svein, Andelic Nada
a Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway.
b Faculty of Medicine , University of Oslo , Oslo , Norway.
Brain Inj. 2017;31(3):329-335. doi: 10.1080/02699052.2016.1255778. Epub 2017 Jan 17.
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.
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.
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.
The study results support the view that individual factors generally outweigh injury-related factors as predictors of disability after TBI, except for PTA.
评估中重度创伤性脑损伤（TBI）后整体残疾的纵向轨迹，并研究这些轨迹是否可由社会人口统计学和损伤特征预测。
从医疗记录中提取105例中重度TBI患者的人口统计学和损伤特征。在1年、2年和5年随访时，通过GOSE评估与TBI相关的残疾情况。使用分层线性模型（HLM）检查受伤后长达5年的功能结局，以及这些结局是否可由以下因素预测：时间、性别、年龄、关系、教育程度、伤前就业情况、职业、格拉斯哥昏迷量表（GCS）、损伤原因、创伤后遗忘（PTA）时长、CT检查结果和损伤严重程度评分，以及这些预测因素与时间之间的相互作用。
受伤时年龄较小、PTA较短，以及时间PTA和时间就业的交互项可预测较高的GOSE轨迹（较低的残疾程度）。受伤时已就业者的残疾程度随时间降低，而未就业者的残疾程度增加。
研究结果支持以下观点，即除PTA外，在TBI后残疾的预测方面，个体因素通常比损伤相关因素更具影响力。
