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Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Outcomes after Complicated and Uncomplicated Mild Traumatic Brain Injury at Three- and Six-Months Post-Injury: Results from the CENTER-TBI Study
Author(s): Voormolen, Daphne C
Zeldovich, Marina
Haagsma, Juanita A
Polinder, Suzanne
Friedrich, Sarah
Maas, Andrew I R
Wilson, Lindsay
Steyerberg, Ewout W
Covic, Amra
Andelic, Nada
Plass, Anne Marie
Wu, Yi-Jhen
Asendorf, Thomas
von Steinbüechel, Nicole
Keywords: Traumatic brain injury
generic and disease-specific health-related quality of life
complicated mild traumatic brain injury
functional outcome
Issue Date: May-2020
Citation: Voormolen DC, Zeldovich M, Haagsma JA, Polinder S, Friedrich S, Maas AIR, Wilson L, Steyerberg EW, Covic A, Andelic N, Plass AM, Wu Y, Asendorf T & von Steinbüechel N (2020) Outcomes after Complicated and Uncomplicated Mild Traumatic Brain Injury at Three- and Six-Months Post-Injury: Results from the CENTER-TBI Study. Journal of Clinical Medicine, 9 (5), Art. No.: 1525.
Abstract: The objective of this study was to provide a comprehensive examination of the relation of complicated and uncomplicated mild traumatic brain injury (mTBI) with multidimensional outcomes at three- and six-months after TBI. We analyzed data from the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) research project. Patients after mTBI (Glasgow Coma scale (GCS) score of 13–15) enrolled in the study were differentiated into two groups based on computed tomography (CT) findings: complicated mTBI (presence of any traumatic intracranial injury on first CT) and uncomplicated mTBI (absence of any traumatic intracranial injury on first CT). Multidimensional outcomes were assessed using seven instruments measuring generic and disease-specific health-related quality of life (HRQoL) (SF-36 and QOLIBRI), functional outcome (GOSE), and psycho-social domains including symptoms of post-traumatic stress disorder (PTSD) (PCL-5), depression (PHQ-9), and anxiety (GAD-7). Data were analyzed using a multivariate repeated measures approach (MANOVA-RM), which inspected mTBI groups at three- and six-months post injury. Patients after complicated mTBI had significantly lower GOSE scores, reported lower physical and mental component summary scores based on the SF-36 version 2, and showed significantly lower HRQoL measured by QOLIBRI compared to those after uncomplicated mTBI. There was no difference between mTBI groups when looking at psychological outcomes, however, a slight improvement in PTSD symptoms and depression was observed for the entire sample from three to six months. Patients after complicated mTBI reported lower generic and disease specific HRQoL and worse functional outcome compared to individuals after uncomplicated mTBI at three and six months. Both groups showed a tendency to improve from three to six months after TBI. The complicated mTBI group included more patients with an impaired long-term outcome than the uncomplicated group. Nevertheless, patients, clinicians, researchers, and decisions-makers in health care should take account of the short and long-term impact on outcome for patients after both uncomplicated and complicated mTBI.
DOI Link: 10.3390/jcm9051525
Rights: This is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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