Functional outcome in traumatic brain injury in Tunisia
Dr Olfa KHARRATa, Dr Ameni Mehrezia KHEZAMIa, Dr Imen MIRIa, Prof Fatma Zahra BEN SALAHa, Prof Catherine DZIRIa
a Institut national d'Orthopédie Kassab
Introduction: Traumatic brain injury (TBI) occurs mainly in young adults in full swing. The objective of this work is to specify the functional outcome of patients with TBI sequelae.
Methods: We included adult patients who were hospitalized between January 2009 and December 2013 for the management of TBI sequelae. We excluded patients with a history of neurological or psychiatric disorders before the TBI. We contacted these patients in an attempt to clarify their current functional status. For each patient we stated: the functional independence measurement (FIM), the severity of disability based on the Glasgow Outcome Scale (GOS). The motor part of the Canadian neurological scale was used to evaluate motor impairments.
Results: 27 patients were included. 89.3% of our patients were male. The mean age was 34.6 (range: 19 to 66 years).The TBI was severe in 19 cases and moderate in 8 patients. The average duration of post-traumatic coma was 38.7 days. Initial FIM was 66.4 / 126. The overall assessment of disability by the GOS found two vegetative states; 9 patients had moderate disability and 16 patients had severe disability. A motor impairment was found in all these patients. Only one patient had resumed his previous occupation; 2 had resumed a professional activity with adaptation of the workplace; and 3 others were following appropriate training.
Conclusion: The socio-professional reintegration remains a difficult goal to achieve, due to neuropsychological disorders in addition to orthopaedic sequelae which often causes neuro dependency and disability. However, it should optimize the residual functional capacity whenever the possibility of a life plan is offered to the patient.
Reference: L. Mailhan. Quality of life after severe head injury. Psychological practices 11 (2005) 343-357
Keywords : traumatic brain injury, evaluation, evolution