Survival and mortality following TBI.

OBJECTIVES: Evaluation of life expectancy (LE) post traumatic brain injury (TBI) is important for planning services for patients and for dealing with medico-legal aspects. We hypothesized that LE for patients who survived 2 years post injury is equal to that of the general population (GP). METHODS: A cohort of 279 patients was assembled during a 5-year period and was followed for 22-27 years. During follow-up, 32 patients (11.5%) died, creating a huge censored data (88.5%). Analyses included standard mortality ratio (SMR), Kaplan-Meier method (KM), Cox proportional hazards regression analysis (PH) and calculations of life expectancy. RESULTS: About 77% of the patients were under 35 years of age at injury. This age cut-off point yielded differences for survival longevity by χ2 tests (p < 0.0001), by KM analysis (p < 0.0001) and by Cox PH regression analysis (p < 0.0001, HR = 13.95). SMR for the entire cohort was 1.86. Shortening of LE in comparison with the GP is 3.58 years. Estimated shortening of LE by severity for mild, moderate and severe injury were -0.51, 4.11 and 13.77 years, respectively. CONCLUSIONS: Patients with mild TBI have a LE similar to the GP, and a reduction in LE was closely related to moderate and severe brain injury.

Validation of the QOLIBRI - Quality of Life after Brain Injury questionnaire in patients after TBI in Israel.

BACKGROUND: The QOLIBRI - Quality of Life after Brain Injury questionnaire was developed by the QOLIBRI Task Force (QTF). Our goal was to investigate the applicability, validity and reliability of the QOLIBRI in Israel. METHODS: Validation of the Hebrew questionnaire was performed after it had been administered to 128 adults with traumatic brain injury (TBI), who were between 3 months' and 15 years' post-discharge from rehabilitation. RESULTS: The internal consistency of the QOLIBRI subscales with the QOLIBRI Total scale was high (Cronbach's α = 0.92); the same was true regarding the correlations between each QOLIBRI subscale and its own items (α = 0.92-0.95). Significant and high Pearson's and Spearman's correlations of the QOLIBRI subscales with demographic and clinical characteristics of the GOSE, ADL, HADS, SF-36, and various aspects of self-reported health status were found. Factor analyses (FA) were applied to confirm the validity of the Hebrew version, using the maximum likelihood method. The six subscales explained 100% of the variance. CONCLUSION: The Hebrew version of the QOLIBRI was found to be useful, meaningful and meeting psychometric criteria in persons after TBI in Israel. The findings support the cross-cultural applicability of the QOLIBRI, regardless of cultural and social differences.