Abstract
BackgroundThe outcome following traumatic brain injury (TBI) is heterogeneous and poorly defined and physical disability scales like the extended Glasgow Outcome Score (GOSE) while providing valuation information in terms of broad categorisation of outcome are unlikely to capture the full spectrum of deficits. Quality of life questionnaires such as SF-36 are emerging as potential tools to help characterise factors important to patients’ recovery. This study assessed the association between physical disability and subjective health rating. The relationship is of value as it may help evaluate the impact of TBI on patients’ lives and facilitate the delivery of appropriate neuro-rehabilitation services.MethodsA single-centre retrospective study was undertaken to assess the relationship between physical outcome as measured by GOSE and quality of life captured by the SF-36 questionnaire. Cronbach’s alpha was calculated for each of the eight SF-36 domains to measure internal consistency of the test. Multivariate analysis of variance was conducted to look at the association between GOSE and the physical (PCS) and mental (MCS) component scores on the SF-36. Finally, we performed a generalised linear mixed model (GLMM) to assess the relative contribution of GOSE score, age at the time of trauma, sex and TBI duration towards MCS and PCS rating.ResultsThere is a statistically significant difference in the MCS and PCS scores based on patients’ GOSE scores. The mean scores of the eight SF-36 domains showed significant association with GOSE. GLMM demonstrated that GOSE was the strongest predictor of PCS and MCS. Age was an important variable in the PCS score while time following trauma was a significant predictor of MCS rating.ConclusionsThis study highlights that patients’ physical outcome following TBI is a strong predictor of the subjective mental and physical health. Nevertheless, there remains tremendous variability in individual SF-36 scores for each GOSE category, highlighting that additional factors play a role in determining quality of life.
Highlights
Traumatic brain injury (TBI) is a leading cause of mortality and long-term disability among those under 45 and costs an estimated $75 billion each year in the USA alone [9, 12]
generalised linear mixed model (GLMM) demonstrated that Glasgow Outcome Score (GOSE) was the strongest predictor of physical component summary (PCS) and mental component summary (MCS)
Age was an important variable in the PCS score while time following trauma was a significant predictor of MCS rating
Summary
Traumatic brain injury (TBI) is a leading cause of mortality and long-term disability among those under 45 and costs an estimated $75 billion each year in the USA alone [9, 12]. When compared to objective clinical measures of physical function, QoL questionnaires are superior at capturing the patients’ internal judgment of health and factors that may be important to the well being of the individual. This emphasis on Patient Reported Outcome Measures (PROM) is drawing increased interest from both patient groups and funding bodies. The outcome following traumatic brain injury (TBI) is heterogeneous and poorly defined and physical disability scales like the extended Glasgow Outcome Score (GOSE) while providing valuation information in terms of broad categorisation of outcome are unlikely to capture the full spectrum of deficits. We performed a generalised linear mixed model (GLMM) to assess the relative contribution of GOSE score, age at the time of trauma, sex and TBI duration towards MCS and PCS rating
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