Abstract
BackgroundFatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities.MethodsPatients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subjective fatigue was measured by single item on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), administered at baseline, three and 6 months postinjury. Patients were categorized by clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU). Injury severity, preinjury somatic- and psychiatric conditions, depressive and sleep problems were registered at baseline. For prediction of fatigue changes, descriptive statistics and mixed effect logistic regression analysis are reported.ResultsFatigue was experienced by 47% of patients at baseline, 48% at 3 months and 46% at 6 months. Patients admitted to ICU had a higher probability of experiencing fatigue than those in ER and ADM strata. Females and individuals with lower age, higher education, more severe intracranial injury, preinjury somatic and psychiatric conditions, sleep disturbance and feeling depressed postinjury had a higher probability of fatigue.ConclusionA high and stable frequency of fatigue was found during the first 6 months after TBI. Specific socio-demographic factors, comorbidities and injury severity characteristics were predictors of fatigue in this study.
Highlights
Fatigue is defined as "the awareness of a decreased capacity for mental and/or physical activity, because of an imbalance in the availability, utilization or restoration of resources1 3 Vol.:(0123456789)Journal of Neurology (2021) 268:61–73 needed to perform activities" [1]
The significant interaction effect between time and age suggested that the patient group < 49 years tended to report higher fatigue scores initially and decreased over time, e.g. reported less fatigue, whereas patients ≥ 49 years reported less fatigue symptoms initially and fatigue slightly increased over time (Fig. 3)
This large-scale, observational longitudinal study assessed the frequency of fatigue following traumatic brain injury (TBI), fatigue changes across clinical care pathways, severity of injury, and predictors of fatigue severity levels
Summary
Journal of Neurology (2021) 268:61–73 needed to perform activities" [1] It is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). Other studies have suggested that longstanding fatigue is not limited to patients with sTBI, and may be exacerbated or caused by emotional and cognitive symptoms, sleep disturbances, and pain across all injury severities [29, 30]. Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Females and individuals with lower age, higher education, more severe intracranial injury, preinjury somatic and psychiatric conditions, sleep disturbance and feeling depressed postinjury had a higher probability of fatigue. Specific socio-demographic factors, comorbidities and injury severity characteristics were predictors of fatigue in this study
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