THE LONG-TERM OUTCOME OF HEAD-INJURY - IMPLICATIONS FOR SERVICE PLANNING

As most of those experiencing traumatic brain injury tend to be young, disabled survivors will be gradually accruing in each locality as eac h year passes. How many need continuing care a decade after injury? Ho w many need day care, or need help with finding work, or continuing su pport for carers? 190 patients who had been admitted to two UK regiona l neurosurgical units on average some 7 years earlier were followed up . With an average age of 29 years these patients stayed in hospital fo r an average 33 days. At follow-up 23% were classified as having moder ate disability or worse on the Glasgow Outcome Scale, including 7.4% w ho had died subsequent to discharge. Survivors were given a neuropsych ological assessment and a socioeconomic interview. Of the survivors, 1 7% had failed to make a good recovery, but 36% were failing to occupy their time in a meaningful way. Age over 30 at time of injury, not occ upied before injury, and above-average length of stay were some of the predictors for failing to occupy time. Quality of life was severely c urtailed for those who could not occupy their time, as was the case fo r their carers. Appropriate counselling, Vocational evaluation and fam ily support in the early years following injury may help to improve qu ality of life for both the head-injured person and their carers.