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慢性创伤性脑损伤幸存者死亡率相关的身体、认知和心理社会特征:美国国立残疾、独立生活和康复研究所在创伤性脑损伤模型系统的一项研究

Physical, Cognitive, and Psychosocial Characteristics Associated With Mortality in Chronic TBI Survivors: A National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems Study.

作者信息

OʼNeil-Pirozzi Therese M, Ketchum Jessica M, Hammond Flora M, Philippus Angela, Weber Erica, Dams-OʼConnor Kristen

机构信息

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation, Hospital and Department of Communication Sciences and Disorders, Northeastern University, Boston (Dr O'Neil-Pirozzi); Research Department, Craig Hospital and Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado (Dr Ketchum); Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Research Department, Craig Hospital, Englewood, Colorado (Ms Philippus); Kessler Foundation, East Hanover, New Jersey (Dr Weber); and Departments of Rehabilitation Medicine and Neurology, Icahn School of Medicine at Mount Sinai, New York (Dr Dams-O'Connor).

出版信息

J Head Trauma Rehabil. 2018 Jul/Aug;33(4):237-245. doi: 10.1097/HTR.0000000000000365.

Abstract

OBJECTIVE

To compare a group of individuals who died more than 1 year posttraumatic brain injury (TBI) with a matched group of survivors and to identify physical function, cognitive function, and/or psychosocial function variables associated with mortality.

DESIGN

Secondary analysis of data from a multicenter longitudinal cohort study.

SETTING

Acute inpatient rehabilitation facilities and community follow-up.

PARTICIPANTS

Individuals 16 years and older with a primary diagnosis of TBI.

MAIN OUTCOME MEASURES

Functional Independence Measure (FIM), Disability Rating Scale, Participation Assessment with Recombined Tools Objective, Extended Glasgow Outcome Scale, Satisfaction With Life Scale.

RESULTS

Individuals who died were distinguishable from their surviving counterparts. They demonstrated significantly poorer global functioning on all physical, cognitive, and psychosocial functioning variables at their most recent study follow-up visit prior to death. FIM Motor demonstrated the largest difference between survival groups, suggesting that independence in mobility may be particularly indicative of likelihood of longer-term survival.

CONCLUSIONS

These findings may inform continued research to elucidate functional characteristics of individuals postchronic TBI prior to their death and to identify opportunities for prevention of accelerated death and interventions to improve health, longevity, and quality of life.

摘要

目的

比较一组创伤性脑损伤(TBI)后1年以上死亡的个体与一组匹配的幸存者,并确定与死亡率相关的身体功能、认知功能和/或心理社会功能变量。

设计

对多中心纵向队列研究的数据进行二次分析。

设置

急性住院康复设施和社区随访。

参与者

16岁及以上原发性诊断为TBI的个体。

主要结局指标

功能独立性测量(FIM)、残疾评定量表、综合工具参与度客观评定、扩展格拉斯哥预后量表、生活满意度量表。

结果

死亡个体与存活个体存在差异。在死亡前最近一次研究随访中,他们在所有身体、认知和心理社会功能变量上的整体功能明显较差。FIM运动功能在存活组之间差异最大,表明行动独立性可能特别预示着长期存活的可能性。

结论

这些发现可能为后续研究提供参考,以阐明慢性创伤性脑损伤个体在死亡前的功能特征,并确定预防加速死亡以及改善健康、寿命和生活质量的干预措施的机会。

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