Haller Chiara S, Delhumeau Cecile, De Pretto Michael, Schumacher Rahel, Pielmaier Laura, Rebetez Marie My Lien, Haller Guy, Walder Bernhard
a Department of Psychology , Harvard University, Cambridge , Boston , MA , USA.
b Division of Public Psychiatry , Massachusetts Mental Health Center , Boston , MA , USA.
Brain Inj. 2017;31(3):319-328. doi: 10.1080/02699052.2016.1255777. Epub 2017 Jan 23.
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).
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.
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 = 0.22, p < 0.0001) was age dependent (slope = -0.06, p = 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 = 1.52, p < 0.0001) was not age dependent (slope = -0.30, p = 0.083). SF-12 mental component scale scores were unchanged.
Disability decreased and HRQoL improved after TBI between 3-12 months. In geriatric patients this improvement was relevant for HRQoL only.
本研究旨在调查非老年（≤65岁）和老年患者（>65岁）创伤性脑损伤（TBI）后3、6和12个月的残疾情况及健康相关生活质量（HRQoL）。
本前瞻性多中心研究纳入了年龄≥16岁且遭受严重TBI（头部区域简明损伤量表>3）的患者。结局指标包括格拉斯哥扩展预后量表（GOSE；残疾情况）、SF-12（HRQoL）。进行了混合线性模型分析。
共纳入351例患者（中位年龄=50岁；四分位间距（IQR）=27-67）；73.2%为男性，27.6%为老年患者。3、6和12个月时的GOSE中位数分别为5（IQR=3-7）、6（IQR=4-8）和7（IQR=5-8）；这种改善（斜率=0.22，p<0.0001）与年龄有关（斜率=-0.06，p=0.003）。3、6和12个月时SF-12身体成分量表评分中位数分别为42.1（IQR=33.6-50.7）、46.6（IQR=37.4-53.9）和50.4（IQR=39.2-55.1）；这种改善（斜率=1.52，p<0.0001）与年龄无关（斜率=-0.30，p=0.083）。SF-12心理成分量表评分无变化。
TBI后3至12个月残疾情况减轻，HRQoL改善。在老年患者中，这种改善仅与HRQoL相关。
