Outcome one year post severe traumatic brain injury: About a Tunisian population

Abstract

The main objective of this study was to investigate the epidemiological characteristics, functional and socio-professional outcome of a population of individuals one year after a severe traumatic brain injury (TBI). The following parameters were analysed: profession, mechanism of trauma, period of care in rehabilitation, initial GCS, imaging results, nature of neuro-orthopedic sequelae, cognitive disorders, and functional level assessed by the FIM (Functional Independence Measure). The handicap was evaluated by the Glasgow outcome scale (GOS). The socio-professional status after TBI (lifestyle, occupation and education) was also investigated. The average age of the 50 patients included in the study was 28.1 ± 15.3 years, mostly male (76%). Length of stay in functional rehabilitation averaged 8.7 ± 14.7 months. All patients included in this study were socially active before the accident and lived with their family. Only 7 patients had returned to work and only 8 patients had resumed their schooling. Problems with memory, executive functions and thinking were reported in 42% of cases. The behavioural troubles (frontal syndrome and emotional problem health) were noted in 40% of cases. The average value of the FIM was 84.1 ± 29. According to the GOS, 30% of patients had a good recovery, and 2 patients remained in persistent vegetative state. Our study population is relatively young and predominantly male. Rehabilitation management takes place very late and the rate of socio-professional reintegration is very low. These findings highlight the importance of providing coordinated medical rehabilitation and intensive care unit to promote social outcomes after severe TBI.