Relatives' reports of long term problems following traumatic brain injury or subarachnoid haemorrhage

Abstract

Purpose: To describe and compare the late outcome of traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH) in terms of the carers' perspectives, and their symptoms' profiles. Method: Postal survey to surviving patients who had been discharged from a Regional Neurosurgical Unit five to seven years previously. There were 288 patients identified retrospectively from hospital records, of whom 209 (126 TBI and 83 SAH) were alive and traced at follow-up. The Glasgow Outcome Scale (GOS) and the Relative's Questionnaire (RQ) were used. Results: Relative's questionnaires were returned by 128 patients; 70 TBI and 58 SAH, giving response rates of 56% and 70% respectively. In terms of outcome, there was a high degree of similarity between groups. On the GOS, approximately half of each group were classified as moderately disabled (49% and 48% of the TBI and SAH groups respectively); a quarter remained severely disabled (27% and 22% ); and the remaining quarter were adjudged to have made a good recovery (24% and 29% ). There was a considerable overlap in terms of the most commonly reported symptoms. Cognitive and physical problems tended to be more commonly reported by relatives of the TBI patients, whilst emotional and subjective symptoms were reported equally in both patient groups. Conclusions: The effects of TBI and SAH persist for many years post-injury, leading to considerable disability and increased dependency. Although the demographic details and mechanisms of injury in these two patient groups differ, there is a high degree of similarity in the pattern of sequelae reported by carers.