Objective: To systematically review prospective cohort studies that investigated prognostic factors associated with long-term activity limitations or participation restrictions and productivity after a traumatic brain injury.
Data sources: PubMed and Psychinfo were searched from 1995 to April 2005, and references were checked.
Review methods: Publications were selected if the study assessed prognostic factors for activity limitations or participation restrictions at least one year post injury; outcome was measured with another or additional measure besides the Glasgow Outcome Scale; the design was a prospective cohort study of adult traumatic brain injury patients; the article was a full-text article written in English, French, German or Dutch. Two reviewers independently assessed methodological quality. A study was considered as `high quality' if it satisfied at least half of the maximum available quality score.
Results: Thirty-five articles reporting on 14 cohorts were included. Due to heterogeneity in prognostic factors and outcome measures, a best-evidence synthesis was performed. All cohorts were of high quality. Strong evidence for predicting disability was found for older age, pre-injury unemployment, pre-injury substance abuse, and more disability at rehabilitation discharge. Strong prognostic factors for being non-productive were pre-injury unemployment, longer post-traumatic amnesia, more disability at rehabilitation admission, and pre-injury substance abuse.
Conclusion: Older age, pre-injury unemployment, pre-injury substance abuse and more disability at rehabilitation discharge are important predictors of long-term disability. Pre-injury unemployment, longer post-traumatic amnesia, more disability at rehabilitation admission and pre-injury substance abuse are important predictors of being non-productive.
Get full access to this article
View all access options for this article.
References
1.
Langlois JA, Rutland-Brown W., Thomas KETraumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2004.
2.
Andlin-Sobocki P., Jonsson B., Wittchen HU, Olesen J.Cost of disorders of the brain in Europe. Eur J Neurol2005; 12(suppl 1): 1—27.
3.
A systematic review of brain injury epidemiology in Europe . Acta Neurochir (Wien)2006; 148: 255—68; discussion 68.
4.
Berg J., Tagliaferri F., Servadei F.Cost of trauma in Europe. Eur J Neurol2005 ; 12(suppl 1): 85—90.
5.
Thurman DJ, Alverson C., Dunn KA, Guerrero J., Sniezek JETraumatic brain injury in the United States: a public health perspective. J Head Trauma Rehabil1999; 14: 602—15.
6.
World Health Organization.International Classification of Functioning, Disability and Health. WHO, 2002.
7.
Jennett B., Bond M.Assessment of outcome after severe brain damage. Lancet1975; 1: 480—84.
8.
Jennett B., Snoek J., Bond MR, Brooks N.Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry1981; 44: 285—93.
9.
Scholten-Peeters GG, Verhagen AP, Bekkering GE et al. Prognostic factors of whiplashassociated disorders: a systematic review of prospective cohort studies. Pain2003; 104: 303—22.
10.
Altman DGSystematic reviews of evaluations of prognostic variables. BMJ2001; 323: 224—28.
11.
Mazzini L., Zaccala M., Gareri F., Giordano A., Angelino E.Long-latency auditory-evoked potentials in severe traumatic brain injury. Arch Phys Med Rehabil2001; 82: 57—65.
12.
Gerhart KA, Mellick DC, Weintraub AHViolence-related traumatic brain injury: a population-based study. J Trauma2003; 55: 1045—53.
13.
Duong TT, Englander J., Wright J. et al. Relationship between strength, balance, and swallowing deficits and outcome after traumatic brain injury: a multicenter analysis. Arch Phys Med Rehabil2004; 85: 1291—97.
14.
Hammond FM, Hart T., Bushnik T., Corrigan JD, Sasser H.Change and predictors of change in communication, cognition, and social function between 1 and 5 years after traumatic brain injury. J Head Trauma Rehabil2004; 19: 314—28.
15.
Hammond FM, Grattan KD, Sasser H. et al. Five years after traumatic brain injury: a study of individual outcomes and predictors of change in function. NeuroRehabilitation2004; 19: 25—35.
16.
Coleman RD, Rapport LJ, Ergh TC et al. Predictors of driving outcome after traumatic brain injury. Arch Phys Med Rehabil2002; 83: 1415—22.
17.
Keyser-Marcus LA, Bricout JC, Wehman P. et al. Acute predictors of return to employment after traumatic brain injury: a longitudinal follow-up. Arch Phys Med Rehabil2002; 83: 635—41.
18.
Boake C., Millis SR, High Jr WM et al. Using early neuropsychologic testing to predict long-term productivity outcome from traumatic brain injury. Arch Phys Med Rehabil2001; 82: 761—68.
19.
Gollaher K. , High W., Sherer M. et al. Prediction of employment outcome one to three years following traumatic brain injury (TBI). Brain Inj1998; 12: 255—63.
20.
Cifu DX, Keyser-Marcus L., Lopez E. et al. Acute predictors of successful return to work 1 year after traumatic brain injury: a multicenter analysis. Arch Phys Med Rehabil1997; 78: 125—31.
21.
Ross SR, Millis SR, Rosenthal M.Neuropsychological prediction of psychosocial outcome after traumatic brain injury. Appl Neuropsychol1997; 4: 165—70.
22.
Harrison-Felix C., Zafonte R., Mann N. et al. Brain injury as a result of violence: preliminary findings from the traumatic brain injury model systems. Arch Phys Med Rehabil1998; 79: 730—37.
23.
Englander J. , Cifu DX, Wright JM, Black K.The association of early computed tomography scan findings and ambulation, self-care, and supervision needs at rehabilitation discharge and at 1 year after traumatic brain injury. Arch Phys Med Rehabil2003; 84: 214—20.
24.
Englander J. , Cifu D., Wrigley M. et al. The impact of acute complications, fractures, and motor deficits on functional outcome and length of stay after traumatic brain injury: a multicenter analysis. J Head Trauma Rehabil1996; 11: 15—26.
25.
Sanders B., Kreutzer JS, Rosenthal P., Delmonico RL, Young MEA multicenter longitudinal investigation of return to work and community integration following traumatic brain injury. J Head Trauma Rehabil1996; 11: 70—84.
26.
Rosenthal P. , Dijkers M., Harrison-Felix C. et al. Impact of minority status on functional outcome and community integration following traumatic brain injury. J Head Trauma Rehabil1996; 11: 40—57.
27.
Mellick D., Gerhart KA, Whiteneck GGUnderstanding outcomes based on the post-acute hospitalization pathways followed by persons with traumatic brain injury. Brain Inj2003; 17: 55—71.
28.
Keith RA, Granger CV, Hamilton BB, Sherwin FSThe functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil1987; 1: 6—18.
29.
Linacre JM, Heinemann AW, Wright BD, Granger CV, Hamilton BBThe structure and stability of the functional independence measure. Arch Phys Med Rehabil1994; 75: 127—32.
30.
Stineman MG, Shea JA, Jette A. et al. The functional independence measure: tests of scaling assumptions, structure, and reliability across 20 diverse impairment categories. Arch Phys Med Rehabil1996; 77: 1101—108.
31.
Easterbrook PJ, Berlin JA, Gopalan R., Matthews DRPublication bias in clinical research. Lancet1991; 337: 867—72.
32.
Spikman JM, Timmerman ME, Zomeren van AH, Deelman BGRecovery versus retest effects in attention after closed head injury. J Clin Exp Neuropsychol1999; 21: 585—605.
33.
van der Naalt J., van Zomeren AH, Sluiter WJ, Minderhoud JMOne year outcome in mild to moderate head injury: the predictive value of acute injury characteristics related to complaints and return to work. J Neurol Neurosurg Psychiatry1999; 66: 207—13.
34.
van der Naalt J., van Zomeren AH, Sluiter WJ, Minderhoud JMAcute behavioural disturbances related to imaging studies and outcome in mild-to-moderate head injury. Brain Inj2000; 14: 781—88.
35.
Sherer M., Bergloff P., High Jr W., Nick TGContribution of functional ratings to prediction of longterm employment outcome after traumatic brain injury. Brain Inj1999 ; 13: 973—81.
36.
Ponsford JL , Olver JH, Curran C., Ng K.Prediction of employment status 2 years after traumatic brain injury. Brain Inj1995; 9: 11—20.
37.
Dawson DR, Levine B., Schwartz ML, Stuss DTAcute predictors of real-world outcomes following traumatic brain injury: a prospective study. Brain Inj2004; 18: 221—38.
38.
Temkin NR, Holubkov R., Machamer JE, Winn HR, Dikmen SSClassification and regression trees (CART) for prediction of function at 1 year following head trauma. J Neurosurg1995 ; 82: 764—71.
39.
Dikmen SS, Ross BL, Machamer JE, Temkin NROne year psychosocial outcome in head injury. J Int Neuropsychol Soc1995; 1: 67—77.
40.
Felmingham KL, Baguley IJ, Crooks J.A comparison of acute and postdischarge predictors of employment 2 years after traumatic brain injury. Arch Phys Med Rehabil2001; 82: 435—39.
41.
Pierallini A., Pantano P., Fantozzi LM et al. Correlation between MRI findings and long-term outcome in patients with severe brain trauma. Neuroradiology2000; 42: 860—67.
42.
Bogner JA, Corrigan JD, Mysiw WJ, Clinchot D., Fugate L.A comparison of substance abuse and violence in the prediction of long-term rehabilitation outcomes after traumatic brain injury. Arch Phys Med Rehabil2001; 82: 571—77.
43.
Bogner JA, Corrigan JD, Fugate L., Mysiw WJ, Clinchot D.Role of agitation in prediction of outcomes after traumatic brain injury. Am J Phys Med Rehabil2001; 80: 636—44.
44.
Corrigan JD , Bogner JA, Mysiw WJ, Clinchot D., Fugate L.Life satisfaction after traumatic brain injury . J Head Trauma Rehabil2001; 16: 543—55.
45.
Webb CR, Wrigley M., Yoels W., Fine PRExplaining quality of life for persons with traumatic brain injuries 2 years after injury. Arch Phys Med Rehabil1995; 76: 1113—19.
46.
Mazzini L., Cossa FM, Angelino E. et al. Posttraumatic epilepsy: neuroradiologic and neuropsychological assessment of long-term outcome. Epilepsia2003; 44: 569—74.
47.
Mazzini L., Pisano F., Zaccala M. et al. Somatosensory and motor evoked potentials at different stages of recovery from severe traumatic brain injury. Arch Phys Med Rehabil1999; 80: 33—39.
48.
Stemmer B., Gahl B., Lacher S., Schoenle PWPredicting vocational and independence status from early assessment of motor, cognitive, and social abilities in traumatic brain injury patients. Brain Cogn2000; 44: 25—30.
49.
Woischneck D., Firsching R., Ruckert N. et al. Clinical predictors of the psychosocial long-term outcome after brain injury. Neurol Res1997; 19: 305—10.
