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Surrogate Perception of Disability after Hospitalization for Traumatic Brain Injury.

Amelia W Maiga1,2, Madison Cook3, Mina F Nordness1

  • 1From the Division of Acute Care Surgery (Maiga, Nordness, Rakhit, Patel), Vanderbilt University Medical Center, Nashville, TN.

Journal of the American College of Surgeons
|January 12, 2024
PubMed
Summary
This summary is machine-generated.

Family caregivers view severe traumatic brain injury (TBI) outcomes as worse than death, differing from public opinion. These perceptions of disability after TBI can inform patient care decisions.

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Area of Science:

  • Neuroscience
  • Public Health
  • Health Economics

Background:

  • The Glasgow Outcome Scale Extended (GOSE) measures recovery after traumatic brain injury (TBI).
  • Public perception studies indicate some GOSE states are rated as worse than death.
  • Family experience with TBI patients may influence views on post-TBI disability.

Purpose of the Study:

  • To assess surrogate preferences for post-TBI GOSE states.
  • To determine health utilities associated with varying levels of TBI-related disability.
  • To explore sociodemographic factors influencing these perceptions.

Main Methods:

  • A national cross-sectional computer-adaptive survey of TBI surrogates was conducted.
  • Surrogates used a standard gamble approach to evaluate GOSE states (GOSE 2-8).
  • Health utilities were calculated, and associations with sociodemographic factors were analyzed.

Main Results:

  • 91% of surrogates rated GOSE 2 (unaware) as worse than death; 65% rated GOSE 3 (severe disability) worse than death.
  • GOSE 4 (partial assistance) was rated worse than the general population by surrogates.
  • Married surrogates and those with higher strength of faith reported higher utility scores.

Conclusions:

  • A significant proportion of surrogates perceive severe TBI outcomes as worse than death.
  • Surrogate perceptions of TBI disability differ from general public views.
  • Understanding these long-term perceptions can improve shared decision-making in neurotrauma care.