Functional recovery after brain injury: Independent predictors of psychosocial outcome one year after TBI.

ABSTRACT

INTRODUCTION: Traumatic Brain Injury (TBI) is the leading cause of death and disability in people aged under 40 in the UK. Many patients suffer residual deficits, which limits their functional recovery. The aim of this study was to determine independent predictors of functional outcome at 1-year post-TBI. METHODS: Utilising a prospective observational cohort design, 1131 consecutive adult admissions with non-recurrent TBI were recruited from the ED (Emergency Department). Using routine consultant-led follow up clinics, data was collected between August 2011 and July 2015. The Rivermead Head Injury Follow Up Questionnaire (RHFUQ) was used to measure psychosocial function at 1 year. RESULTS: A multiple linear regression model showed that previous psychiatric history (p < 0.001), lower Glasgow Coma Scale (p < 0.001), a severe CT scan (p = 0.002), aetiology of assault compared to sport (p = 0.011) and falls (p = 0.005), initial unemployment (p < 0.001) and no job at 8-10 weeks (p < 0.001) after TBI had a significant association with a worse RHFUQ score at 1 year. Follow up rate was >90 %. CONCLUSIONS: This study adds valuable information on the prognostic indicators of TBI recovery and possible targets for intervention. Future development of a validated prognostic model to predict long term functional outcomes after TBI will help improve long-term treatment of the condition.