The Relationship between Injury Characteristics and Post-Traumatic Recovery after Diffuse Axonal Injury.

Autor:	Vieira RCA; Department of Nursing, University of Sergipe, Lagarto 49400-000, Brazil.; Nursing School, University of Sao Paulo, Sao Paulo 05508-010, Brazil., Pipek LZ; Department of Neurology, Clinical Hospital of the University of Sao Paulo, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil., Oliveira DV; Department of Medicine, University of Sergipe, Lagarto 49400-000, Brazil., Paiva WS; Division of Neurosurgery, Clinical Hospital of the University of Sao Paulo, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil., Sousa RMC; Nursing School, University of Sao Paulo, Sao Paulo 05508-010, Brazil.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2024 Jan 29; Vol. 12 (2). Date of Electronic Publication: 2024 Jan 29.
DOI:	10.3390/biomedicines12020311
Abstrakt:	Background: The diagnosis and prognosis of diffuse axonal injury (DAI) remain challenging. This research aimed to analyze the impact on activities of daily living (ADL), functional outcomes, quality of life (QoL), and the association between lesion severity and DAI location identified through imaging exams. Methods: This prospective cohort study included 95 patients diagnosed with DAI. Data were collected at admission, three, six, and twelve months post-injury. The associations between variables were evaluated using a mixed-effects model. Results: Functional recovery and QoL improved between three and twelve months after DAI. An interaction was observed between independence in performing ADL and subarachnoid hemorrhage ( p = 0.043) and intraventricular hemorrhage ( p = 0.012). Additionally, an interaction over time was observed between the Glasgow Outcome Scale (GOS) and DAI severity ( p < 0.001), brain lesions ( p = 0.014), and the Disability Rating Scale (DRS) with injury in brain hemispheres ( p = 0.026) and Adams classification ( p = 0.013). Interaction effects over time were observed with the general health perceptions and energy/vitality domains with intraventricular hemorrhage, and the social functioning domain with the obliteration of basal cisterns and Gentry's classification. Conclusion: The use of CT in the acute phase of DAI is important for predicting outcomes. The severity and location of DAI are associated with functional outcomes, ADL, and QoL.
Databáze:	MEDLINE
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