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Functional Recovery and Life Satisfaction in the First Year After Severe Traumatic Brain Injury: A Prospective Multicenter Study of a Norwegian National Cohort

Anke, Audny MD, PhD; Andelic, Nada MD, PhD; Skandsen, Toril MD, PhD; Knoph, Rein MD; Ader, Tiina MD; Manskow, Unn RN, MPH; Sigurdardottir, Solrun CPsych, PhD; Røe, Cecilie MD, PhD

Journal of Head Trauma Rehabilitation: July/August 2015 - Volume 30 - Issue 4 - p E38–E49
doi: 10.1097/HTR.0000000000000080
Original Articles

Objectives: (1) To examine the impact of demographic and acute injury-related variables on functional recovery and life satisfaction after severe traumatic brain injury (sTBI) and (2) to test whether postinjury functioning, postconcussive symptoms, emotional state, and functional improvement are related to life satisfaction.

Design: Prospective national multicenter study.

Setting: Level 1 trauma centers in Norway.

Participants: 163 adults with sTBI.

Main Measures: Functional recovery between 3 and 12 months postinjury measured with Glasgow Outcome Scale Extended, Rivermead Postconcussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale, and satisfaction with life situation.

Results: 60% of cases experienced functional improvement from 3 to 12 months postinjury. Multivariate logistic regression analysis revealed that discharge to a rehabilitation department from acute care (odds ratio [OR] = 2.14; P < .05) and fewer days with artificial ventilation (OR = 1.04; P < .05) were significantly related to improvement. At 12 months postinjury, 85% were independent in daily activities. Most participants (63%) were satisfied with their life situation. Regression analysis revealed that older age (>65 years), low education, better functional outcome, and the absence of depressive and postconcussion symptoms were significant (P < .05) predictors of life satisfaction. Functional improvement was significantly associated with emotional state but not to life satisfaction.

Conclusion: Following sTBI, approximately two-thirds of survivors improve between 3 and 12 months postinjury and are satisfied with their life. Direct discharge from acute care to specialized rehabilitation appears to increase functional recovery.

Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway (Drs Anke and Manskow); Faculty of Health Sciences, Department of Clinical Medicine, University of Tromso, Norway (Dr Anke); Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway (Drs Andelic and Røe); Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway (Dr Skandsen); Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim, Norway (Dr Skandsen); Department of Physical Medicine and Rehabilitation, Sorlandet Hospital, Kristiansand, Norway (Dr Knoph); Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway (Dr Ader); Faculty of Health Sciences, Department of Health and Care Sciences, University of Tromso, Norway (Dr Manskow); Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway (Dr Sigurdardottir); and Faculty of Medicine, University of Oslo, Oslo, Norway (Dr Røe).

Corresponding Author: Audny Anke, MD, PhD, Department of Rehabilitation, University Hospital of North Norway, Sykehusveien 1, Tromsø, Troms 9016, Norway (audny.anke@uit.no).

This study was conducted with grants from the Norwegian Research Council, grant number 185267.

The authors declare no conflicts of interest.

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