Disability in young people and adults one year after head injury: prospective cohort study
Disability in patients admitted to hospital with a head injury is far higher than expected because previous work has not studied properly representative patient groups and because classification on arrival at hospital underestimates later problems. Support and rehabilitation after discharge are also inadequate, according to a study in this week's BMJ.
Researchers in Scotland tracked the progress of over 2,500 young people and adults (aged 14 years or more) admitted to hospital with a head injury. They found that the initial severity of injury (classified as mild, moderate or severe) was not closely related to the level of disability in survivors one year later. Most survivors of severe head injury (78%) were disabled, yet disability was also common and occurred with similar frequency in survivors of mild (51%) and moderate (54%) injuries. In addition, the authors found that, of the disabled survivors, less than half were seen in hospital after discharge, only 28% reported having received any form of rehabilitation and only 15% had contact with social work services.
The authors acknowledge that research into head injuries is fraught with difficulties, yet such failure to achieve a good recovery - even among young patients with no "adverse" factors in this study - lead the authors to conclude "that it may be inappropriate to class these injuries as 'mild'." They also recognise the lack of support and rehabilitation for disabled survivors and suggest that further investigations are needed to evaluate services to promote recovery.
Contact:
Professor Graham Teasdale Department of Neurosurgery, University of Glasgow, Southern General NHS Trust, Glasgow G51 4TF Email: y.mitchell@clinmed.gla.ac.uk
Please note: contact on Thursday 15 June is Ms Sharon Thornhill: