Objective

To determine factors influencing long-term functional and professional outcomes in patients post severe traumatic brain injury (STBI).

Material/patients and methods

A descriptive analytical transversal and cross-sectional study involving patients with STBI dated more than 1 year and managed in rehabilitation department on an outpatient basis. Described parameters were: coma duration, post-traumatic amnesia duration (PTA), duration of hospitalization in intensive care unit, rehabilitation delay management, brain imaging findings, motor impairment, neuropsychological impairment assessed with Neurobehavioral Rating Scale-Revised (NRS-R), functional outcomes assessed with Functional Independence Measure (FIM) and disability assessed with Glasgow Outcome Scale (GOS).

Results

Three years post-STBI, motor impairment was severe in 34% of cases. Neuropsychological impairments were common: memory disorders (89.6%), attention-deficit disorder (81.2%), irritability (64.6%). Dependency in activities of daily living according to FIM was severe and total in 44% of cases and disability was severe in 44% of cases according to GOS. Factors significantly associated with bad functional outcomes (FIM and GOS) were: coma duration ( P : 0.014), PTA ( P < 0.001) and hospitalization duration ( P < 0,001). We noticed that patients with brain injuries, such as cerebral contusion; cerebral oedema and subarachnoid hemorrhage have a poor recovery. The vocational reintegration rate was at 22%. Patients who failed to return to work had mainly severe motor impairment and an altered FIM or GOS. APT duration and the length of hospitalization in intensive care unit were correlated to return to work.

Discussion–conclusion

It is important to determine and to understand factors influencing patient’s prognosis after severe traumatic brain injury allowing us to improve functional and professional outcomes of this population. The current study confirmed the impact of APT and coma duration on functional recovery and professional activities resumption.