A longitudinal study of health-related quality of life after traumatic brain injury

OBJECTIVE: To examine the longitudinal course of health-related quality of life from 1 month to 3 to 5 years after traumatic brain injury (TBI). DESIGN: Longitudinal cohort study with 4 evaluation points. SETTING: Level I trauma center. PARTICIPANTS: Consecutive hospital admissions of 133 adolescents and adults with complicated mild to severe TBI who completed the outcome measure at all 4 time points, 111 general trauma patients, and 87 healthy friend controls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Sickness Impact Profile. RESULTS: TBI patients reported significant limitations at 1 month postinjury, with substantial improvement occurring by 6 months, especially in the physical domain. Psychosocial improvement was smaller, and perceived cognitive, emotional, and communication difficulties did not change over the time period assessed. Persons with TBI had clear difficulties relative to healthy peers, but their reported level of difficulties was very similar to that of the persons who had sustained a general trauma by 1 year postinjury. CONCLUSIONS: In this sample, TBI was associated with significant early limitations in most aspects of everyday life. Considerable improvement was noted over the first 6 months postinjury, especially in physical domains. Some aspects of psychosocial functioning also improved, although reported limitations in communication, cognitive, and emotional domains remained constant over time. These findings highlight the persistence of injury-related difficulties that compromise quality of life.