外伤性脑损伤后的多维分类与预后预测。

IF 2.4 3区 医学 Q2 CLINICAL NEUROLOGY
Jennie L Ponsford, Gershon Spitz, Phillipa Pyman, Sarah Carrier, Amelia J Hicks, Jack V Nguyen, Angelle M Sander, Mark Sherer
{"title":"外伤性脑损伤后的多维分类与预后预测。","authors":"Jennie L Ponsford, Gershon Spitz, Phillipa Pyman, Sarah Carrier, Amelia J Hicks, Jack V Nguyen, Angelle M Sander, Mark Sherer","doi":"10.1097/HTR.0000000000001018","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify outcome clusters among individuals with traumatic brain injury (TBI), 6 months to 10 years post-injury, in an Australian rehabilitation sample, and determine whether scores on 12 dimensions, combined with demographic and injury severity variables, could predict outcome cluster membership 1 to 3 years post-injury.</p><p><strong>Setting: </strong>Rehabilitation hospital.</p><p><strong>Participants: </strong>A total of 467 individuals with TBI, aged 17 to 87 (M = 44.2 years), 70% male, with mean post-traumatic amnesia 24 days (range 0.5-455 days), were assessed a mean of 3.4 years post-injury (range 0.5-10 years). A subgroup of 138 participants was also evaluated as rehabilitation inpatients and followed up 1 year post-injury.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Main measures: </strong>TBI Quality of Life subscales (Upper Extremity, Pain Interference, Headache Pain, Anxiety, Resilience, Emotional and Behavioral Dyscontrol, General Cognitive Concerns, Independence, and Economic Quality of Life Scale), Neurobehavioral Symptom Inventory, Family Assessment Device General Functioning Scale, Wechsler Adult Intelligence Scale-IV Letter-Number-Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test Part A, Verbal Fluency Test, Word Memory Test, Participation Assessment with Recombined Tools-Objective, and Glasgow Outcome Scale-Extended.</p><p><strong>Results: </strong>K-means cluster analysis revealed 5 clusters across 12 dimensions: Good Outcome, High Cognition, Poor Cognition, Poor Outcome, and Poor Adjustment, aligning with Sherer and colleagues' clusters. Inpatient assessments (n = 138) identified profiles predictive of outcome group membership. Participants with Good Outcomes exhibited lower anxiety and higher independence, self-esteem, and resilience, despite some cognitive deficits. High Cognition correlated with robust Economic and Family Support. Poor Cognition aligned with impaired cognitive function but positive psychosocial ratings suggest limited self-awareness. Poor Outcome featured low initial cognitive scores and poor psychosocial adjustment. Poor Adjustment participants, without inpatient cognitive impairments, reported persistent pain, physical symptoms, and emotional distress.</p><p><strong>Conclusions: </strong>Findings support the evaluation of cognitive and psychosocial factors during rehabilitation to predict outcomes with potential to inform rehabilitative interventions to optimize outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multidimensional Classification and Prediction of Outcome Following Traumatic Brain Injury.\",\"authors\":\"Jennie L Ponsford, Gershon Spitz, Phillipa Pyman, Sarah Carrier, Amelia J Hicks, Jack V Nguyen, Angelle M Sander, Mark Sherer\",\"doi\":\"10.1097/HTR.0000000000001018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to identify outcome clusters among individuals with traumatic brain injury (TBI), 6 months to 10 years post-injury, in an Australian rehabilitation sample, and determine whether scores on 12 dimensions, combined with demographic and injury severity variables, could predict outcome cluster membership 1 to 3 years post-injury.</p><p><strong>Setting: </strong>Rehabilitation hospital.</p><p><strong>Participants: </strong>A total of 467 individuals with TBI, aged 17 to 87 (M = 44.2 years), 70% male, with mean post-traumatic amnesia 24 days (range 0.5-455 days), were assessed a mean of 3.4 years post-injury (range 0.5-10 years). A subgroup of 138 participants was also evaluated as rehabilitation inpatients and followed up 1 year post-injury.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Main measures: </strong>TBI Quality of Life subscales (Upper Extremity, Pain Interference, Headache Pain, Anxiety, Resilience, Emotional and Behavioral Dyscontrol, General Cognitive Concerns, Independence, and Economic Quality of Life Scale), Neurobehavioral Symptom Inventory, Family Assessment Device General Functioning Scale, Wechsler Adult Intelligence Scale-IV Letter-Number-Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test Part A, Verbal Fluency Test, Word Memory Test, Participation Assessment with Recombined Tools-Objective, and Glasgow Outcome Scale-Extended.</p><p><strong>Results: </strong>K-means cluster analysis revealed 5 clusters across 12 dimensions: Good Outcome, High Cognition, Poor Cognition, Poor Outcome, and Poor Adjustment, aligning with Sherer and colleagues' clusters. Inpatient assessments (n = 138) identified profiles predictive of outcome group membership. Participants with Good Outcomes exhibited lower anxiety and higher independence, self-esteem, and resilience, despite some cognitive deficits. High Cognition correlated with robust Economic and Family Support. Poor Cognition aligned with impaired cognitive function but positive psychosocial ratings suggest limited self-awareness. Poor Outcome featured low initial cognitive scores and poor psychosocial adjustment. Poor Adjustment participants, without inpatient cognitive impairments, reported persistent pain, physical symptoms, and emotional distress.</p><p><strong>Conclusions: </strong>Findings support the evaluation of cognitive and psychosocial factors during rehabilitation to predict outcomes with potential to inform rehabilitative interventions to optimize outcomes.</p>\",\"PeriodicalId\":15901,\"journal\":{\"name\":\"Journal of Head Trauma Rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-01-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Head Trauma Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/HTR.0000000000001018\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Head Trauma Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HTR.0000000000001018","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:本研究旨在确定澳大利亚康复样本中创伤性脑损伤(TBI)患者在损伤后6个月至10年的结果集群,并确定12个维度的得分,结合人口统计学和损伤严重程度变量,是否可以预测损伤后1至3年的结果集群成员。单位:康复医院。参与者:共有467名TBI患者,年龄17至87岁(M = 44.2岁),70%为男性,平均创伤后遗忘24天(范围0.5-455天),平均损伤后3.4年(范围0.5-10年)进行评估。一个亚组138名参与者也被评估为康复住院患者,并在损伤后随访1年。设计:前瞻性观察研究。主要措施:TBI生活质量量表(上肢、疼痛干扰、头痛、焦虑、恢复力、情绪和行为控制障碍、一般认知问题、独立性和经济生活质量量表)、神经行为症状量表、家庭评估装置一般功能量表、韦氏成人智力量表- iv字母数字排序和编码、Rey听觉言语学习测试、轨迹制作测试A部分、言语流畅性测试、单词记忆测试、使用重组工具的参与评估-目标和格拉斯哥结果量表-扩展。结果:K-means聚类分析在12个维度上显示出5个聚类:良好结果、高认知、差认知、差结果和差调整,与Sherer和同事的聚类一致。住院患者评估(n = 138)确定了预测结果组成员的概况。结果良好的参与者表现出较低的焦虑和较高的独立性、自尊和适应力,尽管有一些认知缺陷。高认知与强大的经济和家庭支持相关。认知能力差与认知功能受损有关,但积极的社会心理评分表明自我意识有限。不良预后表现为初始认知评分低和心理社会适应差。适应性差的参与者,没有住院认知障碍,报告持续疼痛、身体症状和情绪困扰。结论:研究结果支持康复过程中认知和社会心理因素的评估,以预测结果,并有可能为康复干预提供信息,以优化结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multidimensional Classification and Prediction of Outcome Following Traumatic Brain Injury.

Objectives: This study aimed to identify outcome clusters among individuals with traumatic brain injury (TBI), 6 months to 10 years post-injury, in an Australian rehabilitation sample, and determine whether scores on 12 dimensions, combined with demographic and injury severity variables, could predict outcome cluster membership 1 to 3 years post-injury.

Setting: Rehabilitation hospital.

Participants: A total of 467 individuals with TBI, aged 17 to 87 (M = 44.2 years), 70% male, with mean post-traumatic amnesia 24 days (range 0.5-455 days), were assessed a mean of 3.4 years post-injury (range 0.5-10 years). A subgroup of 138 participants was also evaluated as rehabilitation inpatients and followed up 1 year post-injury.

Design: Prospective observational study.

Main measures: TBI Quality of Life subscales (Upper Extremity, Pain Interference, Headache Pain, Anxiety, Resilience, Emotional and Behavioral Dyscontrol, General Cognitive Concerns, Independence, and Economic Quality of Life Scale), Neurobehavioral Symptom Inventory, Family Assessment Device General Functioning Scale, Wechsler Adult Intelligence Scale-IV Letter-Number-Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test Part A, Verbal Fluency Test, Word Memory Test, Participation Assessment with Recombined Tools-Objective, and Glasgow Outcome Scale-Extended.

Results: K-means cluster analysis revealed 5 clusters across 12 dimensions: Good Outcome, High Cognition, Poor Cognition, Poor Outcome, and Poor Adjustment, aligning with Sherer and colleagues' clusters. Inpatient assessments (n = 138) identified profiles predictive of outcome group membership. Participants with Good Outcomes exhibited lower anxiety and higher independence, self-esteem, and resilience, despite some cognitive deficits. High Cognition correlated with robust Economic and Family Support. Poor Cognition aligned with impaired cognitive function but positive psychosocial ratings suggest limited self-awareness. Poor Outcome featured low initial cognitive scores and poor psychosocial adjustment. Poor Adjustment participants, without inpatient cognitive impairments, reported persistent pain, physical symptoms, and emotional distress.

Conclusions: Findings support the evaluation of cognitive and psychosocial factors during rehabilitation to predict outcomes with potential to inform rehabilitative interventions to optimize outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.80
自引率
4.20%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The Journal of Head Trauma Rehabilitation is a leading, peer-reviewed resource that provides up-to-date information on the clinical management and rehabilitation of persons with traumatic brain injuries. Six issues each year aspire to the vision of “knowledge informing care” and include a wide range of articles, topical issues, commentaries and special features. It is the official journal of the Brain Injury Association of America (BIAA).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信