Quality of Life Level in the Patients with the Sequelae of Traumatic Brain Injury: Comparing Mild to Severe Cases

Kim, Sung Woo; Rho, Seung Ho

Abstract

This study was designed to investigate the differences of quality of life(QOL) between traumatic brain injury(TBI) and control groups, and also between mild traumatic, brain injury (MTBI) and severe traumatic brain injury (STBI) groups, in term of the global, the psychosocial and the neurobehavioral aspects of QOL. Twenty-three patients with MTBI, 23 patients with STBI and 31 normal control group were rated with a global measure(Quality of Life Index ; QOLI), a psychosocial measure(Sickness Impact Profile SIP), and a self-rating(Head Injury Symptom Checklist ; HISCL) and an objective symptom scales(Neurobehavioral Rating Scale ; NRS) The result were as follows : 1) Comparison with a control group showed that the brain-injured had expenenced significant impairment in QOL measured by above all scales(p<.01). 2) On QOLI of the patients with TBI, the decrement of QOL was not significantly different between MTBI and STBI groups. In these groups, the severity of impairment was highest in acfivify(involvement in own occupation) and the next was outlook in life. 3) On the data from SIP, psychosocial dysfunction was significantly greater in MTBI than STBI(p<.05), whereas physical impairment was similar in both groups of TBI. 4) The severity of subjective complaints on HISCL was significantly greater in(p<.05). Particularly MTBI patients experienced more severe distress from pain, noise sensitivity, and insomnia than STBI patients(p<.05). 5) On NRS, the severity of objective symptoms of both TBI groups was highest in somatic concern, depressed mood, and anxiety in decreasing order. MTBI groups had significandy higher scores than STBI group on the subscales of somatic concern, depressed mood, fatigue, and inaffention(p<.05). In summary, the decrement of QOL in the MTBI group was much the same as STBI groups. These data suggest that symptomatic MTBI as well as STBI patients may experience impaired QOL in a number of domain well beyond the acute post-injury phases, and that severity of injury, defined by duration of loss of consciousness and post-traumatic amnesia, and finding of neuroimaging techniques, is not apperaciable related to the QOL.