Comparison of long-term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury?
Comparison of long-term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury?
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DOI：
10.1016/j.injury.2014.07.012
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发表时间：
2015-01-01
影响因子：
2.5
通讯作者：
Ponsford, Jennie
中科院分区：
文献类型：
--
作者：
Dahm, Jane;Ponsford, Jennie
目的：虽然已经充分证明创伤性脑损伤（TBI）会导致长期的认知、行为和情感困难，但人们对这些结果与创伤性骨科损伤（TOI）有何不同了解较少。本研究的目的是比较 TBI、TOI 患者和未受伤对照者在受伤后 5-10 年的自我报告结果。据推测，患有 TBI 的参与者会有更大的认知困难；患有 TOI 和 TBI 的参与者会有相似的功能和身体结果，但都比对照组差；参与者和方法：88 名患有复杂轻度至重度 TBI 的个体和 96 名在住院康复期间患有 TOI 的个体在受伤后 5-10 年进行了随访，同时对 48 名对照者进行了类似时期的随访。对整体功能（GOS-E）、生活质量（SF-36）、心理健康（SCL-90-R、HADS、PCL-S）、社会心理困难（SIP）、认知困难（SF-36 COG）、疼痛（BPI）和疲劳（FSS）进行自我报告测量。结果：TBI和TOI患者的结果与对照组显着不同，整体功能较差，心理困扰和疼痛干扰更大。只有患有 TBI 的参与者比对照组有更大的认知困难和焦虑，并且不太可能就业或建立关系。 TBI 参与者比 TOI 参与者报告了更大的焦虑、PTSD、心理困扰和心理社会困难。结论：TOI 和 TBI 都会导致长期残疾、疼痛干扰和心理困扰。然而，认知障碍、失业、缺乏长期关系、焦虑和创伤后应激障碍是创伤性脑损伤后更严重的长期问题。这项研究的结果对于管理与这些伤害群体相关的风险和调整康复以改善长期结果具有重要意义。 (C) 2014 Elsevier Ltd. 保留所有权利。
Objective: Whilst it has been well-demonstrated that traumatic brain injury (TBI) results in long-term cognitive, behavioural and emotional difficulties, less is understood about how these outcomes differ from those following traumatic orthopaedic injury (TOI). The aim of this study was to compare self-reported outcomes at 5-10 years post-injury for those with TBI, TOI, and uninjured controls. It was hypothesised that participants with TBI would have greater cognitive difficulties; participants with TOI and TBI would have similar functional and physical outcomes, both being poorer than controls; and participants with TBI would have poorer psychosocial outcomes than those with TOI.Participants and methods: Eighty-eight individuals with complicated mild to severe TBI and 96 with TOI recruited during inpatient rehabilitation were followed up 5-10 years post-injury, together with 48 controls followed over a similar period. Self-report measures of global functioning (GOS-E), quality of life (SF-36), psychological wellbeing (SCL-90-R, HADS, PCL-S), psychosocial difficulties (SIP), cognitive difficulties (SF-36 COG), pain (BPI), and fatigue (FSS) were administered.Results: Outcomes for individuals with TBI and TOI differed significantly from controls, with poorer global functioning, and greater psychological distress and interference from pain. Only participants with TBI reported greater cognitive difficulties and anxiety than controls, and were less likely to be employed or in a relationship. Participants with TBI reported greater anxiety, PTSD, psychological distress and psychosocial difficulties than those with TOI.Conclusions: Both TOI and TBI cause long-term disability, interference from pain, and psychological distress. However, cognitive impairments, unemployment, lack of long-term relationships, anxiety and PTSD are more substantial long-term problems following TBI. Findings from this study have implications for managing risks associated with these injury groups and tailoring rehabilitation to improve long-term outcomes. (C) 2014 Elsevier Ltd. All rights reserved.