| Autor: |
Patel MB; 1 Veterans Affairs (VA) Tennessee Valley Healthcare System , Nashville VA, Nashville, Tennessee.; 2 Department of Surgery and Neurosurgery, Vanderbilt University School of Medicine , Nashville, Tennessee., Wilson LD; 3 Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine , Nashville, Tennessee., Bregman JA; 2 Department of Surgery and Neurosurgery, Vanderbilt University School of Medicine , Nashville, Tennessee., Leath TC; 2 Department of Surgery and Neurosurgery, Vanderbilt University School of Medicine , Nashville, Tennessee., Humble SS; 2 Department of Surgery and Neurosurgery, Vanderbilt University School of Medicine , Nashville, Tennessee., Davidson MA; 4 Department of Biostatistics, Vanderbilt University School of Medicine , Nashville, Tennessee., de Riesthal MR; 3 Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine , Nashville, Tennessee., Guillamondegui OD; 2 Department of Surgery and Neurosurgery, Vanderbilt University School of Medicine , Nashville, Tennessee. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of neurotrauma [J Neurotrauma] 2015 Jul 01; Vol. 32 (13), pp. 984-9. Date of Electronic Publication: 2015 Apr 24. |
| DOI: |
10.1089/neu.2014.3652 |
| Abstrakt: |
This investigation describes the relationship between TBI patient demographics, quality of life outcome, and functional status outcome among clinic attendees and non-attendees. Of adult TBI survivors with intracranial hemorrhage, 63 attended our TBI clinic and 167 did not attend. All were telephone surveyed using the Extended-Glasgow Outcome Scale (GOSE), the Quality of Life after Brain Injury (QOLIBRI) scale, and a post-discharge therapy questionnaire. To determine risk factors for GOSE and QOLIBRI outcomes, we created multivariable regression models employing covariates of age, injury characteristics, clinic attendance, insurance status, post-discharge rehabilitation, and time from injury. Compared with those with severe TBI, higher GOSE scores were identified in individuals with both mild (odds ratio [OR]=2.0; 95% confidence interval [CI]: 1.1-3.6) and moderate (OR=4.7; 95% CI: 1.6-14.1) TBIs. In addition, survivors with private insurance had higher GOSE scores, compared with those with public insurance (OR=2.0; 95% CI: 1.1-3.6), workers' compensation (OR=8.4; 95% CI: 2.6-26.9), and no insurance (OR=3.1; 95% CI: 1.6-6.2). Compared with those with severe TBI, QOLIBRI scores were 11.7 points (95% CI: 3.7-19.7) higher in survivors with mild TBI and 17.3 points (95% CI: 3.2-31.5) higher in survivors with moderate TBI. In addition, survivors who received post-discharge rehabilitation had higher QOLIBRI scores by 11.4 points (95% CI: 3.7-19.1) than those who did not. Survivors with private insurance had QOLIBRI scores that were 25.5 points higher (95% CI: 11.3-39.7) than those with workers' compensation and 16.8 points higher (95% CI: 7.4-26.2) than those without insurance. Because neurologic injury severity, insurance status, and receipt of rehabilitation or therapy are independent risk factors for functional and quality of life outcomes, future directions will include improving earlier access to post-TBI rehabilitation, social work services, affordable insurance, and community resources. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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