Outcome following traumatic brain injury: a comparison between 2 and 5 years after injury

TLDR

This study examined long‑term outcomes in traumatic brain injury patients after discharge from rehabilitation and highlighted the need to adapt rehabilitation systems for lifelong intervention. Of 254 TBI patients assessed at 2 years, 103 were followed up at 5 years using structured interviews covering neurological symptoms, mobility, ADL independence, productivity, relationships, communication, and cognitive, behavioural and emotional changes. At 5 years, patients still reported visual difficulties, headache, and fatigue, yet showed greater independence in personal, domestic, and community ADL and transport use, with more returning to driving, while a higher incidence of cognitive, behavioural, and emotional changes and a 32 % drop in employment among those working at 2 years underscored the need for lifelong intervention.

Abstract

Thisstudy examined long-term outcomein traumatically brain-injured individualsfollowing discharge from a comprehensive rehabilitation programme. Of 254 traumatic brain injury (TBI) patients reviewed at 2 years, 103 have been followed up at 5 years using a structured interview format detailing neurological symptoms, mobility, independence in ADL, productivity status, relationship issues, communication and the presence of cognitive, behavioural and emotional changes. Visual difficulties, headache and fatigue were persistent in a significant number of patients. Between 2 and 5 years there was increased independence in personal, domestic and community ADL and the use of transport. Ten more patients had returned to driving. On the other hand there was a slightly higher incidence of cognitive, behavioural and emotional changes reported at 5 years. Thirty-two per cent of those working at 2 years were not employed at 5 years. Many students had also become unemployed. These findings suggest the need for intermittent lifelong intervention following TBI. Systems of rehabilitation need to be adapted to provide this.