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Disability in young people and adults after head injury: 12–14 year follow-up of a prospective cohort
Open accessAbstract
BACKGROUND: There is a need to establish how long term outcome evolves after head injury (HI) and factors related to this, to inform opportunities for intervention. OBJECTIVE: To determine late outcome in adults 12-14 years after hospital admission for HI and to examine relationships between injury, early and late factors, and disability. METHODS: A prospective cohort with HI, whose outcome was reported previously at 1 and 5-7 years after injury, were followed up after 12-14 years. Participants were assessed using structured and validated measures of disability (Glasgow Outcome Scale-Extended), psychological well being, alcohol use and health status. RESULTS: Of 219 survivors followed-up at 5-7 years, 34 (15.5%) had died by 12-14 years. Disability remained common in survivors at 12-14 years (51%), as found at 1 and 5-7 years (53%). For those disabled at 1 year, outcome was poor, with 80% dead or disabled at 12-14 years. Older age at injury, a premorbid history of brain illness or physical disability and post-injury low self-esteem and stress were associated with disability at 12-14 years. Disability changed between 5-7 and 12-14 years in 55% of survivors, improving in 23%. Late changes in disability between 5-7 and 12-14 years were associated with self-perceptions of locus of control as being 'powerful others' at 5-7 years. CONCLUSIONS: Disability is common 12-14 years after hospital admission with a HI. For some there is a dynamic process of change in disability over time that is associated with self-perceptions of control that could be a target for intervention based research.
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“Nevertheless, uncertainty remains as to how early TBI exposure is related to a broader set of specific medical and social functioning outcomes in adulthood [10,21,22], such as premature mortality, disability pension, and educational attainment.”
From Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes (2016) · cites this paper as [10]
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“Epidemiological studies have consistently found higher rates of adverse outcomes in adults who have sustained a TBI when compared to the general population [7–16].”
From Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes (2016) · cites this paper as [10]
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“Similar results have been reported in studies examining global disability indices [10], such as the extended Glasgow Outcome Scale (GOSE) [21].”
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“In a prospective cohort of more than 200 TBI survivors followed for up to 12 to 14 years, neurobehavioral disability worsened over time in a significant number (25).”
Background
Metadata
- Authors
- McMillan, T. M., Teasdale, G. M., & Stewart, E.
- Affiliations
- University of Glasgow (GB)
- Corresponding author
- McMillan, Thomas M
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2012-05-29
- Volume
- 83
- Issue
- 11
- Pages
- 1086-1091
- ISSN
- 0022-3050 (ISSN-L)
- 1468-330X
- OpenAlex
- W2162231203
- Cited by
- 315
- References
- 42
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 14 · 2023: 13 · 2022: 13 · 2021: 14 · 2020: 24 · 2019: 25 · 2018: 14 · 2017: 19 · 2016: 22 · 2015: 29 · 2014: 22 · 2013: 21 · 2012: 20
- FWCI
- 21.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- traumatic brain injury, long-term outcomes, disability, adolescents, young adults, Glasgow Outcome Scale-Extended, mortality, self-esteem, locus of control, psychological well-being, alcohol consumption, health status, age at injury
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Aged, Aged, 80 and over, Disability Evaluation, Female, Follow-Up Studies, Craniocerebral Trauma, Health Status, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors, Outcome Assessment, Health Care, Glasgow Outcome Scale
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