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Disability in young people and adults after head injury: 12-14 year follow up of a prospective cohort

McMillan, T. , Teasdale, G. and Stewart, E. (2012) Disability in young people and adults after head injury: 12-14 year follow up of a prospective cohort. Journal of Neurology, Neurosurgery and Psychiatry, 83(11), pp. 1086-1091. (doi: 10.1136/jnnp-2012-302746)

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Abstract

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 one and 5-7 years (53%). For those disabled at 1 year, outcome was dismal, 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 head injury. 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.

Item Type:	Articles
Status:	Published
Refereed:	Yes
Glasgow Author(s) Enlighten ID:	Stewart, Ms Elaine and Teasdale, Sir Graham and McMillan, Professor Tom
Authors:	McMillan, T., Teasdale, G., and Stewart, E.
Subjects:	R Medicine > RA Public aspects of medicine
College/School:	College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Research Group:	Mental Health and Wellbeing
Journal Name:	Journal of Neurology, Neurosurgery and Psychiatry
ISSN:	0022-3050
ISSN (Online):	1468-330X
Published Online:	29 May 2012
Copyright Holders:	Copyright © 2012 BMJ Publishing Group
First Published:	First published in Journal of Neurology, Neurosurgery and Psychiatry
Publisher Policy:	Reproduced in accordance with the copyright policy of the publisher

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References

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Deposit and Record Details

ID Code:	64193
Depositing User:	Professor Tom McMillan
Datestamp:	15 May 2012 11:55
Last Modified:	22 Sep 2021 22:51
Date of first online publication:	29 May 2012