Abstract
BackgroundThe Quality of Life after Brain Injury (QOLIBRI) score was developed to assess disease-specific health-related quality of life (HRQoL) after traumatic brain injury (TBI). So far, validation studies on the QOLIBRI were only conducted in cohorts with traumatic brain injury. This study investigated the longer-term residuals in severely injured patients, focusing specifically on the possible impact of major TBI.MethodsIn a prospective questionnaire investigation, 199 survivors with an injury severity score (ISS) > 15 participated in one-year follow-up. Patients who had sustained major TBI (abbreviated injury scale, AIS head > 2) were compared with patients who had no or only mild TBI (AIS head ≤ 2). Univariate analysis (ANOVA, Cohen’s kappa, Pearson’s r) and stepwise linear regression analysis (B with 95% CI, R, R2) were used.ResultsThe total QOLIBRI revealed no differences in one-year outcomes between patients with versus without major TBI (75 and 76, resp.; p = 0.68). With regard to the cognitive subscore, the group with major TBI demonstrated significantly more limitations than the one with no or mild TBI (p < 0.05). The AIS head correlated significantly with the cognitive dimension of the QOLIBRI (r = − 0.16; p < 0.05), but not with the mental components of the SF-36 or the TOP. In multivariate analysis, the influence of the severity of head injury (AIS head) on total QOLIBRI was weaker than that of injured extremities (R2 = 0.02; p < 0.05 vs. R2 = 0.04; p = 0.001) and equal to the QOLIBRI cognitive subscore (R2 = 0.03, p < 0.01 each).ConclusionsGiven the unexpected result of similar mean QOLIBRI total score values and only minor differences in cognitive deficits following major trauma independently of whether patients sustained major brain injury or not, further studies should investigate whether the QOLIBRI actually has the discriminative capacity to detect specific residuals of major TBI. In effect, the score appears to indicate mental deficits following different types of severe trauma, which should be evaluated in more detail.Trial registrationNCT02165137; retrospectively registered 11 June 2014.
Highlights
The Quality of Life after Brain Injury (QOLIBRI) score was developed to assess disease-specific healthrelated quality of life (HRQoL) after traumatic brain injury (TBI)
Injured with major Traumatic brain injury (TBI) presented with a mean total QOLIBRI of 74.9, comparable to patients with no or mild TBI (76.1; Table 3)
From a historical point of view, von Steinbüchel et al in their original evaluation studies correctly describe the broad spectrum of HRQoL to be measured by the QOLIBRI [11, 12, 18, 19], they and subsequent authors almost univocally argue for its use in TBI only
Summary
The Quality of Life after Brain Injury (QOLIBRI) score was developed to assess disease-specific healthrelated quality of life (HRQoL) after traumatic brain injury (TBI). The newly developed Quality of Life after Brain Injury score (QOLIBRI) [11] was the first instrument designed to assess disease-specific health-related quality of life (HRQoL) following brain injury [12]. Given the lack of knowledge in the literature on the degree to which cognitive deficits following trauma, whether independently of or dependent upon the TBI sustained, will be reliably identified by scores for HRQoL and functional outcome, we were interested in investigating the QOLIBRI by assessing the longer-term course of patients who had suffered severe trauma (Injury Severity Score (ISS) > 15) and comparing it to other well established outcome scores. Literature searches did not reveal any investigations of the QOLIBRI that involved unselected, i.e. severely injured patients, including those without head injury, or evaluated possible correlations with trauma severity classified by AIS-grading
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