Disability, functioning, and quality of life after moderate to severe traumatic brain injury in Medellín (Colombia)
DOI:
https://doi.org/10.28957/rcmfr.410Keywords:
Traumatic brain injury, Quality of life, depression, anxiety, disability evaluation, Patient Health QuestionnaireAbstract
Introduction. Cranioencephalic traumatisms (CETs) are a common cause of death and disability worldwide.
Objective. To describe the disability, functioning, depression, anxiety, and quality of life in patients with moderate or severe CET in the first 90 days after suffering the injury.
Methods. Cross-sectional study conducted with adult patients who suffered a moderate or severe CET in Medellín (Colombia) and its metropolitan area.
Results. 153 patients with CET, 87 severe and 66 moderate, were included. The most frequent cause of the injury was motorcycle traffic accidents, the mean age of the participants was 48.3 (SD=19.4) years, 79.7% were men and 46.4% were single. At the time of the trauma, 70.6% were under the influence of alcohol or psychoactive substances and 44.4% were working on their own. In the diagnostic images taken in the acute phase, the most frequently observed lesion was subdural hematoma, in 43.79%. Functioning was worse in patients with severe CET as assessed by both the Disability Rating Scale (DRS) (8.79 vs. 3.82) and in all domains of the World Health Organization Disability Assessment Schedule (WHO-DAS II) (the most affected domain was the one of Activities outside home and the least affected was Interpersonal relations). In the cognitive function, the average score in the Montreal Cognitive Assessment (MoCA) was 16 (SD=8.9) in patients with severe CET and 20.2 (SD=6.9) in those with moderate CET. The quality of life was worse in patients with severe CET in all domains, with a worse perception in physical performance. State and trait anxiety were worse in patients with severe CET, although with non-significant differences. Pain on the visual analogue scale was worse in those who had severe CET.
Conclusions. CETs are injuries that can affect the population of productive age and generate pain, anxiety, depression, functioning and cognitive sequelae that impact quality of life, being these consequences more serious in those who suffer severe CETs compared with those with moderate CETs.
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