Quality of life after traumatic brain injury: A systematic review of the literature

In modern industrial countries traumatic brain injury (TBI) is a common seq uel after different kinds of accidents especially amongst young male adults . Apart from medical and economic consequences Quality of Life (QoL) after TBI becomes increasingly important in outcome assessment, Besides the class ical domains of QoL (physical, psychological, social) cognitive impairments are playing an important role especially for TBI patients. In 1991 the Meran conference set important standards and formulated basic g uidelines for defining and measuring QoL in surgery, but a special index fo r TBI patients has not yet been developed. Instead, QoL research concentrat es on physical, medical, psychological and social problems only. Based on the existing QoL concept extended by the cognitive aspect it was t he aim of this review to give an overview about the recent QoL research in TBI patients since 1991. Sixteen studies in TBI patients mentioning at least 2 domains of QoL (physi cal, psychological, social, cognitive) were published since 1991. Five of t hem considered all 4 domains of QoL. All studies except of one dealt with p sychological and social problems. Only half of the studies considered cogni tive impairments. Four studies tried to define QoL, but none of them includ ed the cognitive component. There was no consensus regarding the definition and the choice of measurement instrument for QoL after TBI. This review of 16 studies considering outcome and QoL after TBI confirms th at a homogenous and clinically relevant QoL concept for this group of patie nts is still missing. Further research in TBI patients should include all 4 domains of QoL.