Risk Factors for Long-Term Health-Related Quality-of-Life and Mental Health Outcomes in Traumatic Brain Injury: A...

Area of Science:

• Neuroscience
• Public Health
• Psychiatry

Background:

• Traumatic brain injury (TBI) frequently results in lasting disability, affecting mental health and health-related quality of life (HRQoL).
• Current TBI care is often symptom-driven due to limited resources for routine monitoring.
• There is a need for risk-stratified follow-up and evidence on early prognostic factors for TBI patients.

Purpose of the Study:

• To conduct a systematic review and meta-analysis to identify early risk factors associated with poorer long-term mental health and HRQoL outcomes in adult TBI patients.
• To synthesize existing evidence to inform risk-stratified post-discharge care strategies.

Main Methods:

• Systematic search of seven electronic databases for studies on adult TBI patients with outcomes assessed at least 6 months post-discharge.
• Independent screening, risk of bias assessment, and data extraction by two authors.
• Random-effects meta-analysis and narrative synthesis for effect estimation, adhering to PRISMA guidelines.

Main Results:

• Sixty-four studies (n=334,672) were included; 58% had low risk of bias.
• Female sex, socioeconomic disadvantage, psychiatric history, assaultive injuries, and prior TBI were linked to worse long-term outcomes.
• Assault-related injuries (OR=2.72) and psychiatric history (OR=2.38) significantly increased odds of PTSD; female sex (OR=1.72) and prior TBI (OR=1.52) increased odds of depression.

Conclusions:

• Several readily identifiable factors present before or at discharge predict poor long-term HRQoL and mental health in TBI survivors.
• Leveraging these factors in follow-up protocols and clinical decision support can enable risk-stratified post-TBI care.
• This evidence supports proactive management strategies to improve recovery and quality of life for TBI patients.