Correlates of functional status 3-5 years after traumatic brain injury with CT abnormalities

The Functional Status Examination (FSE) is a relatively new measure of functional outcome after traumatic brain injury (TBI). This study examines functional status limitations and what contributes to them to further enhance interpretability of the FSE and to continue its development as an outcome measure. The measure was given to 209 adults sustaining TBI with CT abnormalities who were followed prospectively until three to five years after injury. Relationships between functional status change as assessed by the FSE and characteristics of the injury and pre-injury characteristics of the person injured were evaluated as were relationships with concurrent measures of neuropsychological, emotional, and psychosocial functioning, health status, quality of life, and other functional status measures. Groups based on degree of functional status limitations due to the injury differ significantly on injury severity, especially length of impaired consciousness. They do not differ on most pre-injury characteristics of the person injured, although pre-existing conditions, primarily alcohol abuse, are more common in those with more negative functional changes after injury. All concurrent measures examined differ significantly among FSE groups with strongest relationships with measures of quality of life, psychosocial functioning, and other measures of health status and functional status (each p < 0.001). The Functional Status Examination shows promise as a measure reflecting a broad range of functional limitations. The FSE is an excellent tool combining clinical relevance, face validity, strong relationships to other measures of relevant constructs (criterion-related validity), and reasonable sensitivity to TBI severity even long after the injury and in a mostly moderately injured group.