Determinants of long-term health-related quality of life in adult patients with mild traumatic brain injury.

purposeMild traumatic brain injury (mTBI) usually leads to the appearance of post-concussion symptoms (PCS) which may resolve after a short time. In this study, the mental and physical aspects of quality of life (QoL) were evaluated 6 months after mTBI, and the association of demographic and injury-related factors, post-injury primary executive function and PCS types with the long-term QoL status was investigated.

methods123 eligible mTBI patients of initial sampling participated in follow-up phase of this longitudinal study. The demographic, clinical, and para-clinical data of patients were recorded. Paraclinical data comprised brain lesion volume, type and location determined by CT scan. The executive function and primary PCS were examined during the discharge using the verbal fluency task and a checklist, respectively. QoL was measured via SF-36 questionnaire. The collected data were entered into SPSS 22, and analyzed using appropriate statistical tests.

resultsYoungers aged between 18 and 35 years and women had a lower QoL score than others. Primary somatic and cognitive PCS together were associated with poor QoL. There was no significant difference in QoL and executive function scores between the normal and abnormal brain CT groups. However, among people with abnormal CT, those having multifocal lesions including at least an intracranial hemorrhage type such as intra parenchymal hemorrhage or extra-axial bleeding together with other intracranial lesions or skull fracture demonstrated less QoL score in SF-36. A significant correlation was discovered between the scores of the executive function and QoL in mental dimensions of SF-36.

conclusionsThis study emphasizes on the clinical significance of early executive function and PCS examination in mTBI population, as well as optimal management of the victims regardless of the initial brain CT findings, especially in high-risk populations.