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Brain Inj. 2016;30(13-14):1665-1671. Epub 2016 Oct 14.

Disability and health-related quality-of-life 4 years after a severe traumatic brain injury: A structural equation modelling analysis.

Author information

1
a Assistance Publique-Hôpitaux de Paris , Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation , Garches , France.
2
b EA 4047 HANDIReSP , Université de Versailles , Saint-Quentin , France.
3
c Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France.
4
d Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Physique et Réadaptation , Paris, France Université Pierre et Marie Curie , Paris , France.
5
e Centre Ressources Francilien du Traumatisme Crânien (CRFTC) , Paris , France.
6
f Antenne UEROS-SAMSAH 92-UGECAM IDF , Hôpital Raymond Poincaré , Garches , France.

Abstract

OBJECTIVES:

To assess predictors and indicators of disability and quality-of-life 4 years after severe traumatic brain injury (TBI), using structural equation modelling (SEM).

METHODS:

The PariS-TBI study is a longitudinal multi-centre inception cohort study of 504 patients with severe TBI. Among 245 survivors, 147 patients were evaluated upon 4-year follow-up, and 85 completed the full assessment. Two outcome measures were analysed separately using SEM: the Glasgow Outcome Scale-extended (GOS-E), to measure disability, and the QOLIBRI, to assess quality-of-life. Four groups of variables were entered in the model: demographics; injury severity; mood and cognitive impairments; somatic impairments.

RESULTS:

The GOS-E was directly significantly related to mood and cognition, injury severity, and somatic impairments. Age and education had an indirect effect, mediated by mood/cognition or somatic deficiencies. In contrast, the only direct predictor of QOLIBRI was mood and cognition. Age and somatic impairments had an indirect influence on the QOLIBRI.

CONCLUSION:

Although this study should be considered as explorative, it suggests that disability and quality-of-life were directly influenced by different factors. While disability appeared to result from an interaction of a wide range of factors, quality-of-life was solely directly related to psycho-cognitive factors.

KEYWORDS:

Traumatic brain injury; outcome; quality-of-life

PMID:
27740857
DOI:
10.1080/02699052.2016.1201593
[Indexed for MEDLINE]

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