Hibbard M R, Uysal S, Sliwinski M, Gordon W A
Department of Rehabilitation Medicine, The Mount Sinai Medical Center, New York, New York, USA.
J Head Trauma Rehabil. 1998 Aug;13(4):47-57. doi: 10.1097/00001199-199808000-00005.
To examine the self-reported prevalence of long-term health issues in individuals with traumatic brain injury (TBI) living in the community.
A structured health interview. For individuals with TBI, the presence of a specific health-related issue with onset post-TBI and currently a problem at the time of the interview was explored. For individuals without disability, a specific health-related issue was evaluated at time of interview. For each health issue, the proportion of individuals with TBI experiencing post-TBI onset but current symptoms was contrasted with symptom reports of individuals without disability. Chi-square statistical analyses were used to determine significance. For individuals with TBI, logistic regressions were used to model the probability of having a particular health difficulty when four covariates were examined, such as age, gender, time since onset of TBI, and duration of loss of consciousness (LOC).
Urban, suburban, and rural New York State.
338 individuals with TBI and 273 individuals without disability between the ages of 18 and 65 years. Individuals with TBI were, on average, 10 years post-onset at the time of interview.
Self-reported health issues reflective of neuroendocrine, neurological, immunosuppression, and other health issues.
Chronic health issues suggestive of ongoing neuroendocrine dysfunctions (ie, changes in hair/skin texture, body temperature changes), neurologic difficulties (ie, headaches, seizures, balance difficulties, spasticity, sleep disturbances, loss of urinary control), and arthritic complaints were significantly more common in individuals with TBI. The prevalence of many of these health-related difficulties was related to duration of LOC but not to time since injury. Age and gender effects were found, with older women with TBI more likely to report thyroid conditions, sleep disturbances, loss of urinary control, and arthritic changes. Women also reported greater frequency of headaches, colds, weight changes, and temperature changes post TBI.
Health issues reflective of neuroendocrine, neurological, and arthritic difficulties are common long-term health issues for individuals with TBI. Proactive patient education, ongoing health screening with appropriate medical follow-up, and timely interventions for individuals with TBI are indicated. Longitudinal studies are necessary to examine the natural course of post-TBI health difficulties.
调查社区中创伤性脑损伤（TBI）患者自我报告的长期健康问题患病率。
结构化健康访谈。对于TBI患者，探讨在TBI发病后出现且在访谈时仍是问题的特定健康相关问题。对于无残疾个体，在访谈时评估一个特定的健康相关问题。对于每个健康问题，将TBI患者中出现TBI后发病但目前有症状的个体比例与无残疾个体的症状报告进行对比。采用卡方统计分析确定显著性。对于TBI患者，当检查年龄、性别、TBI发病后的时间以及意识丧失（LOC）持续时间等四个协变量时，使用逻辑回归对出现特定健康困难的概率进行建模。
纽约州的城市、郊区和农村。
338名年龄在18至65岁之间的TBI患者和273名无残疾个体。TBI患者在访谈时平均发病后10年。
反映神经内分泌、神经、免疫抑制及其他健康问题的自我报告健康问题。
提示持续神经内分泌功能障碍（如头发/皮肤质地改变、体温变化）、神经困难（如头痛、癫痫发作、平衡困难、痉挛、睡眠障碍、尿失禁）和关节炎主诉等慢性健康问题在TBI患者中更为常见。许多这些与健康相关的困难的患病率与LOC持续时间有关，而与受伤后的时间无关。发现了年龄和性别效应，年龄较大的TBI女性更有可能报告甲状腺疾病、睡眠障碍、尿失禁和关节炎变化。女性还报告TBI后头痛、感冒、体重变化和体温变化的频率更高。
反映神经内分泌、神经和关节炎困难的健康问题是TBI患者常见的长期健康问题。需要对患者进行积极的教育，持续进行健康筛查并给予适当的医学随访，以及对TBI患者进行及时干预。有必要进行纵向研究以检查TBI后健康困难的自然病程。
