Disability in young people and adults after head injury: 12-14 year follow-up of a prospective cohort

Thomas M. McMillan, Graham M. Teasdale, Elaine Stewart

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52 Citations (Scopus)

Abstract

BACKGROUND: There is a need to establish how long term outcome evolves after head injury (HI) and factors related to this, to inform opportunities for intervention.

OBJECTIVE: To determine late outcome in adults 12-14 years after hospital admission for HI and to examine relationships between injury, early and late factors, and disability.

METHODS: A prospective cohort with HI, whose outcome was reported previously at 1 and 5-7 years after injury, were followed up after 12-14 years. Participants were assessed using structured and validated measures of disability (Glasgow Outcome Scale-Extended), psychological well being, alcohol use and health status.

RESULTS: Of 219 survivors followed-up at 5-7 years, 34 (15.5%) had died by 12-14 years. Disability remained common in survivors at 12-14 years (51%), as found at 1 and 5-7 years (53%). For those disabled at 1 year, outcome was poor, with 80% dead or disabled at 12-14 years. Older age at injury, a premorbid history of brain illness or physical disability and post-injury low self-esteem and stress were associated with disability at 12-14 years. Disability changed between 5-7 and 12-14 years in 55% of survivors, improving in 23%. Late changes in disability between 5-7 and 12-14 years were associated with self-perceptions of locus of control as being 'powerful others' at 5-7 years.

CONCLUSIONS: Disability is common 12-14 years after hospital admission with a HI. For some there is a dynamic process of change in disability over time that is associated with self-perceptions of control that could be a target for intervention based research.

Original languageEnglish
Pages (from-to)1086-91
Number of pages6
JournalJournal of Neurology, Neurosurgery & Psychiatry
Volume83
Issue number11
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

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Keywords

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Craniocerebral Trauma
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Glasgow Outcome Scale
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment (Health Care)
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't

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