Department of Rehabilitation & Human Performance (Drs Kumar and Dams-O'Connor), and Departments of Rehabilitation Medicine and Neurology (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York City, New York; Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado (Dr Ketchum and Mr Sevigny); Research Department, Craig Hospital, Englewood, Colorado (Dr Ketchum and Mr Sevigny); Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus (Dr Corrigan); and Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (Dr Hammond), and Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond).
J Head Trauma Rehabil. 2020 Jul/Aug;35(4):E372-E381. doi: 10.1097/HTR.0000000000000572.
To evaluate the impact of physical, mental, and total health condition burden on functional outcome and life satisfaction up to 10 years after moderate to severe traumatic brain injury (TBI).
Six TBI Model Systems centers.
Three hundred ninety-three participants in the TBI Model Systems National Database.
Retrospective cohort study.
Self-reported physical and mental health conditions at 10 years postinjury. Functional Independence Measure Motor and Cognitive subscales and the Satisfaction With Life Scale measured at 1, 2, 5, and 10 years.
In 10-year longitudinal individual growth curve models adjusted for covariates and inverse probability weighted to account for selection bias, greater physical and mental health comorbidity burden was negatively associated with functional cognition and life satisfaction trajectories. Physical, but not mental, comorbidity burden was negatively associated with functional motor trajectories. Higher total health burden was associated with poorer functional motor and cognitive trajectories and lower life satisfaction.
This study offers evidence that comorbidity burden negatively impacts longitudinal functional and life satisfaction outcomes after TBI. The findings suggest that better identification and treatment of comorbidities may benefit life satisfaction, functional outcome, reduce healthcare costs, and decrease reinjury. Specific guidelines are needed for the management of comorbidities in TBI populations.
评估身体、心理和整体健康状况负担对中重度创伤性脑损伤（TBI）后 10 年功能结局和生活满意度的影响。
六个 TBI 模型系统中心。
TBI 模型系统国家数据库中的 393 名参与者。
回顾性队列研究。
损伤后 10 年的自我报告身体和心理健康状况。1、2、5 和 10 年时使用功能独立性测量运动和认知分量表以及生活满意度量表进行测量。
在调整协变量和逆概率加权以考虑选择偏差的 10 年纵向个体增长曲线模型中，较高的身体和心理共病负担与功能认知和生活满意度轨迹呈负相关。身体共病负担，但不是心理共病负担，与功能运动轨迹呈负相关。更高的总体健康负担与较差的功能运动和认知轨迹以及较低的生活满意度相关。
本研究提供了证据表明共病负担对 TBI 后功能和生活满意度的纵向结果产生负面影响。研究结果表明，更好地识别和治疗共病可能有益于生活满意度、功能结局、降低医疗成本和减少再损伤。TBI 人群中需要特定的共病管理指南。
