Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury

Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma. Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scal...

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Main Authors: Britt-Marie Stålnacke, Britt-Inger Saveman, Maud Stenberg
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Behavioural Neurology
Online Access:http://dx.doi.org/10.1155/2019/9216931
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author Britt-Marie Stålnacke
Britt-Inger Saveman
Maud Stenberg
author_facet Britt-Marie Stålnacke
Britt-Inger Saveman
Maud Stenberg
author_sort Britt-Marie Stålnacke
collection DOAJ
description Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma. Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury. Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean: 4.4±2.3, BNIS mean: 31.5±7.0) to 1 year (GOSE mean: 5.5±2.7, p=0.003, BNIS mean: 33.2±6.3, p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean: 4.7±2.8, p=0.13, BNIS mean: 33.5±3.9, p=0.424) after the injury. The BNIS subscale “speech/language” at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456, p=0.049). Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.
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spelling doaj-art-8caf7af6bc6b41d0aa2020c75cfcb23d2025-08-20T02:09:33ZengWileyBehavioural Neurology0953-41801875-85842019-01-01201910.1155/2019/92169319216931Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain InjuryBritt-Marie Stålnacke0Britt-Inger Saveman1Maud Stenberg2Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, SwedenDepartment of Nursing, Umeå University, Umeå, SwedenDepartment of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, SwedenAim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma. Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury. Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean: 4.4±2.3, BNIS mean: 31.5±7.0) to 1 year (GOSE mean: 5.5±2.7, p=0.003, BNIS mean: 33.2±6.3, p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean: 4.7±2.8, p=0.13, BNIS mean: 33.5±3.9, p=0.424) after the injury. The BNIS subscale “speech/language” at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456, p=0.049). Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.http://dx.doi.org/10.1155/2019/9216931
spellingShingle Britt-Marie Stålnacke
Britt-Inger Saveman
Maud Stenberg
Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
Behavioural Neurology
title Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
title_full Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
title_fullStr Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
title_full_unstemmed Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
title_short Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
title_sort long term follow up of disability cognitive and emotional impairments after severe traumatic brain injury
url http://dx.doi.org/10.1155/2019/9216931
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AT brittingersaveman longtermfollowupofdisabilitycognitiveandemotionalimpairmentsafterseveretraumaticbraininjury
AT maudstenberg longtermfollowupofdisabilitycognitiveandemotionalimpairmentsafterseveretraumaticbraininjury