Cairns Kathleen, Beaulieu-Bonneau Simon, Jomphe Valérie, Lamontagne Marie-Ève, de Guise Élaine, Moore Lynne, Savard Josée, Sirois Marie-Josée, Swaine Bonnie, Ouellet Marie-Christine
School of Psychology, Université Laval, Québec, QC, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec, QC, Canada.
Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec, QC, Canada; CERVO Research Centre, Québec, QC, Canada.
Arch Phys Med Rehabil. 2025 Mar;106(3):358-365. doi: 10.1016/j.apmr.2024.09.005. Epub 2024 Sep 26.
To (1) detect distinct trajectories of symptoms and quality of life (QoL) over the first 4 years after mild traumatic brain injury (mTBI); (2) assess the relationship between symptom trajectory membership and QoL trajectory membership; and (3) identify participant characteristics associated with QoL trajectory membership.
Prospective longitudinal cohort study. Assessments occurred at 4, 8, 12, 24, 36, and 48 months after mTBI.
Recruitment occurred in Level 1 Trauma Centers; follow-up was completed in the community.
Participants were 143 adults (aged 18-65y) who sustained an mTBI and were hospitalized (≥24h) at a Level 1 Trauma Center.
Not applicable.
Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Insomnia Severity Index, Medical Outcomes Study Cognitive Functioning Scale, Quality of Life after Brain Injury questionnaire, presence/absence of headaches or dizziness.
Group-based trajectory modeling revealed relatively stable symptom and QoL trajectories over time. Considerable percentages of participants were classified in trajectories of clinically significant symptoms throughout the full follow-up period: 62% for subjective cognitive issues, 54% for fatigue, 44% for anxiety, 43% for insomnia, 27% for depression, 23% for headaches, and 17% for dizziness. Sixty-six percent of participants belonged to trajectories of persistently poor QoL. For all symptoms, trajectories of greater severity were associated with trajectories of poorer QoL. None of the sociodemographic or injury-related variables examined were associated with QoL trajectory membership.
A substantial proportion of individuals hospitalized after mTBI experiences clinically significant persistent symptoms ≤4 years after injury, and those with more severe symptoms have poorer QoL. Further research is required to better understand the factors leading to symptom persistence and poor QoL.
（1）检测轻度创伤性脑损伤（mTBI）后最初4年症状及生活质量（QoL）的不同轨迹；（2）评估症状轨迹归属与生活质量轨迹归属之间的关系；（3）确定与生活质量轨迹归属相关的参与者特征。
前瞻性纵向队列研究。在mTBI后4、8、12、24、36和48个月进行评估。
在一级创伤中心招募；在社区完成随访。
143名成年人（年龄18 - 65岁），他们遭受了mTBI并在一级创伤中心住院（≥24小时）。
不适用。
疲劳严重程度量表、医院焦虑抑郁量表、失眠严重程度指数、医学结局研究认知功能量表、脑损伤后生活质量问卷、是否存在头痛或头晕。
基于组的轨迹模型显示，随着时间推移，症状和生活质量轨迹相对稳定。在整个随访期间，相当比例的参与者被归类为具有临床显著症状的轨迹：主观认知问题为62%，疲劳为54%，焦虑为44%，失眠为43%，抑郁为27%头痛为23%，头晕为17%。66%的参与者属于生活质量持续较差的轨迹。对于所有症状，更严重的轨迹与更差的生活质量轨迹相关。所检查的社会人口统计学或与损伤相关的变量均与生活质量轨迹归属无关。
mTBI后住院的相当一部分个体在受伤后≤4年经历了具有临床意义的持续症状，且症状较严重者生活质量较差。需要进一步研究以更好地理解导致症状持续和生活质量差的因素。
