Development of prognostic models for Health-Related Quality of Life following traumatic brain injury

Isabel R.A.Retel Helmrich*, David van Klaveren, Simone A. Dijkland, Hester F. Lingsma, Suzanne Polinder, Lindsay Wilson, Nicole von Steinbuechel, Joukje van der Naalt, Andrew I.R. Maas, Ewout W. Steyerberg, CENTER-TBI collaborators, Erwin Kompanje

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Traumatic brain injury (TBI) is a leading cause of impairments affecting Health-Related Quality of Life (HRQoL). We aimed to identify predictors of and develop prognostic models for HRQoL following TBI. Methods: We used data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Core study, including patients with a clinical diagnosis of TBI and an indication for computed tomography presenting within 24 h of injury. The primary outcome measures were the SF-36v2 physical (PCS) and mental (MCS) health component summary scores and the Quality of Life after Traumatic Brain Injury (QOLIBRI) total score 6 months post injury. We considered 16 patient and injury characteristics in linear regression analyses. Model performance was expressed as proportion of variance explained (R2) and corrected for optimism with bootstrap procedures. Results: 2666 Adult patients completed the HRQoL questionnaires. Most were mild TBI patients (74%). The strongest predictors for PCS were Glasgow Coma Scale, major extracranial injury, and pre-injury health status, while MCS and QOLIBRI were mainly related to pre-injury mental health problems, level of education, and type of employment. R2 of the full models was 19% for PCS, 9% for MCS, and 13% for the QOLIBRI. In a subset of patients following predominantly mild TBI (N = 436), including 2 week HRQoL assessment improved model performance substantially (R2 PCS 15% to 37%, MCS 12% to 36%, and QOLIBRI 10% to 48%). Conclusion: Medical and injury-related characteristics are of greatest importance for the prediction of PCS, whereas patient-related characteristics are more important for the prediction of MCS and the QOLIBRI following TBI.

Original languageEnglish
Pages (from-to)451-471
Number of pages21
JournalQuality of Life Research
Issue number2
Early online dateJul 2021
Publication statusPublished - Feb 2022

Bibliographical note

Funding Information: The research leading to these results was supported by the European Union’s Seventh Framework Programme (FP7/2007-2013) under Grant Agreement n° 602150 (CENTER-TBI). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA), and from Integra LifeSciences Corporation (USA).

Publisher Copyright: © 2021, The Author(s).


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