Functioning and Disability Analysis of Patients with Traumatic Brain Injury and Spinal Cord Injury by Using the World Health Organization Disability Assessment Schedule 2.0

Chia-Ying Kuo,Wen-Chou Chi,Wen-Ta Chiu,Kwang-Hwa Chang,Hung-Yi Chiou,Tsan-Hon Liou,Reuben Escorpizo,Hua-Fang Liao,Chia-Feng Yen,Jo-Ting Tsai

doi:10.3390/ijerph120404116

Abstract

The purpose of this study is to compare traumatic brain injuries (TBI) and spinal cord injuries (SCI) patients’ function and disability by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); and to clarify the factors that contribute to disability. We analyzed data available between September 2012 and August 2013 from Taiwan’s national disability registry which is based on the International Classification of Functioning, Disability, and Health (ICF) framework. Of the 2664 cases selected for the study, 1316 pertained to TBI and 1348 to SCI. A larger percentage of patients with TBI compared with those with SCI exhibited poor cognition, self-care, relationships, life activities, and participation in society (all p < 0.001). Age, sex, injury type, socioeconomic status, place of residence, and severity of impairment were determined as factors that independently contribute to disability (all p < 0.05). The WHODAS 2.0 is a generic assessment instrument which is appropriate for assessing the complex and multifaceted disability associated with TBI and SCI. Further studies are needed to validate the WHODAS 2.0 for TBI and SCI from a multidisciplinary perspective.

Highlights

Injury is a major global health concern
Preliminary data were obtained from a registry of disability evaluation, functional assessment, and provision of social welfare services, which is a database established by the Ministry of Health and Welfare in Taiwan and is based on the International Classification of Functioning, Disability, and Health (ICF) framework [16]
No significant differences in sex, age, education, and urbanization level were observed between the participants with traumatic brain injuries (TBI) and those with spinal cord injuries (SCI) (Table 1)

Summary

Introduction

Injury is a major global health concern. Violence and injury are the leading causes of death in the Western Pacific region among people aged 5–49 years; most of these fatalities arise from road accidents, falls, drowning, burns, and interpersonal violence [1]. Of the various accidental injuries, central nervous system injuries include traumatic brain injury (TBI) and spinal cord injury (SCI) constitute a major cause of morbidity and mortality. TBI and SCI are important because of their severity and long-term effects. Patients with TBI or SCI can have disabilities and pain for years [3,4]. TBI is a major public health concern worldwide; it is a major cause of death and disability and impairs health-related quality of life [5]. Morbidity associated with severe TBI may result in long-term disability and may burden families and society. According to a systematic review, TBI patients that had a longer inpatient hospital had high injury severity, low physical functioning and a reduced chance of returning to work [7]

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