脑外伤长期存活者的长期功能结果和生活质量。

IF 1.8 Q3 CLINICAL NEUROLOGY
Neurotrauma reports Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI:10.1089/neur.2023.0064
Wivi Taalas, Rahul Raj, Juha Öhman, Jari Siironen
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引用次数: 0

摘要

对创伤性脑损伤(TBI)幸存者的早期功能结果评估可能低估了 TBI 的长期后果。我们对重症监护室管理的长期创伤性脑损伤幸存者的功能结果和生活质量的长期时间变化进行了评估。这项前瞻性纵向研究纳入了 2000-2002 年间在一家大学医院住院的 180 名患者,他们在 TBI 术后 15 年仍健在。研究人员收集了包括影像学信息在内的基线特征。使用格拉斯哥结果量表(GOS)和扩展 GOS(GOSE)对早期(6-24 个月)和晚期(15 年)的功能结果进行了评估。15 年后的生活质量采用 EuroQol Five Dimensions Five Levels (EQ-5D-5L) 问卷进行测量。GOS 和 GOSE 被二分为有利和不利结果。通过标准化评估方案计算出 15 年后 EQ-5D-5L 结果的指数得分。在 180 名患者中,有 118 人回答了 15 年的调查问卷。受伤时的中位年龄为 34 岁(四分位数间距为 19-45 岁)。使用 GCS 评估创伤性脑损伤的严重程度,67% 的患者为中度至重度创伤性脑损伤。97%的患者早期功能恢复良好,72%的患者晚期功能恢复良好。逻辑回归发现,较高的年龄、较低的 GCS 和马歇尔 CT III 可显著预测后期不利的功能预后。较高的年龄和马歇尔 CT III 是功能预后恶化的重要预测因素。所有患者的 EQ-5D-5L 指数中位数为 0.88(0.66-1.00),与 GOSE 呈正相关。大多数早期预后良好的长期创伤性脑损伤幸存者的晚期功能预后也很好。高龄和弥漫性脑损伤与神经功能恶化有关。生活质量与功能预后密切相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Functional Outcome and Quality of Life in Long-Term Traumatic Brain Injury Survivors.

Early functional outcome assessments of traumatic brain injury (TBI) survivors may underestimate the long-term consequences of TBI. We assessed long-term temporal changes in functional outcome and quality of life in intensive care unit-managed long-term TBI survivors. This prospective, longitudinal study included 180 patients admitted to a single university hospital during 2000-2002 alive at 15 years post-TBI. Baseline characteristics, including imaging information, were collected. Functional outcome was assessed early (6-24 months) and late (15 years) using the Glasgow Outcome Scale (GOS) and the extended GOS (GOSE). Quality of life was measured at 15 years using the EuroQol Five Dimensions Five Levels (EQ-5D-5L) questionnaire. GOS and GOSE were dichotomized into favorable and unfavorable outcome. An index score was computed for EQ-5D-5L results at 15 years by a standardized valuation protocol. Of 180 patients, 118 replied to 15-year questionnaires. Median age at time of injury was 34 years (interquartile range, 19-45). Using the GCS to assess TBI severity, 67% had a moderate-to-severe TBI. Ninety-seven percent had favorable early functional outcome, and 72% had late favorable functional outcome. Logistic regression found higher age, lower GCS, and Marshall CT III to significantly predict late unfavorable functional outcome. Higher age and Marshall CT III were significant predictors of functional outcome deterioration. Median EQ-5D-5L index score for all patients was 0.88 (0.66-1.00) and correlated positively with GOSE. Most long-term TBI survivors with early favorable outcome also have late favorable functional outcome. Higher age and diffuse brain injury are associated with neurological deterioration. Quality of life was strongly linked to functional outcome.

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CiteScore
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