Heterogeneity of health-related quality of life after mild traumatic brain injury with systemic injury: a cluster analytic approach.

Anderson, Jacqueline F. I.

Purpose: Health-related quality of life (HRQoL) is a key component of evaluating outcome after mild traumatic brain injury (mTBI). As outcome is heterogeneous following mTBI, it is relevant to examine individual differences in HRQoL. This study investigated whether multiple homogenous subgroups could be meaningfully identified, 10 weeks after hospitalised mTBI with systemic injury, on the basis of HRQoL profiles. Methods: Ninety-one adults were assessed for HRQoL, pain, fatigue, sleep quality, psychological distress, cognition and post-concussion symptoms. Results: Cluster analyses revealed three separate subgroups based on physical, mental, social and energy HRQoL. One group (42%) demonstrated normative levels of HRQoL on all subdomains. The remaining two groups demonstrated significantly reduced HRQoL on all subdomains. These groups had equivalently poor mental, social and energy HRQoL, but the smallest group (27%) had significantly poorer physical HRQoL. Multinomial logistic regression revealed that pain significantly and independently predicted group membership for the particularly poor physical HRQoL group. Fatigue was the only significant independent predictor of group membership for the remaining group with reduced HRQoL. Conclusion: These findings suggest more than 50% of hospitalised individuals with mTBI and systemic injury, have reduced HRQoL, 10 weeks after mTBI. Pain and fatigue warrant clinical attention in these individuals. IMPLICATIONS FOR REHABILITATION: Mild traumatic brain injury is a common event that has been shown to be associated with persistently reduced health-related quality of life in approximately 50% of individuals 6 to 12 months after injury. Health-related quality of life likely varies between individuals after injury Relative to the "normal" population, most individuals in this cohort of individuals with mTBI and systemic injury had reduced mental, social and energy quality of life 10 weeks after injury. Fatigue and pain are important factors in reduced health-related quality of life after mTBI with systemic injury. Further research is needed to determine whether these fatigue and pain issues are related to mTBI-factors, such as headache, and/or related to systemic injury factors, which are common in the mTBI population.

REHABILITATION for brain injury patients; CLUSTER analysis (Statistics); PSYCHOLOGICAL distress; COGNITIVE testing; T-test (Statistics); RESEARCH funding; HOSPITAL care; FATIGUE (Physiology); MULTIPLE regression analysis; QUESTIONNAIRES; MULTIVARIATE analysis; DESCRIPTIVE statistics; ODDS ratio; QUALITY of life; RESEARCH; PAIN; POSTCONCUSSION syndrome; ANALYSIS of variance; SLEEP quality; CONFIDENCE intervals; DATA analysis software; SYMPTOMS

Disability & Rehabilitation, 2025, Vol 47, Issue 2, p347

0963-8288

Academic Journal

10.1080/09638288.2024.2345278