A 1-YEAR LONGITUDINAL-STUDY OF SEVERE TRAUMATIC BRAIN INJURY IN AUSTRALIA USING THE SICKNESS IMPACT PROFILE

Objective: To document outcome and to investigate patterns of physical and psychosocial recovery in the first year following severe traumati c brain injury (TBI) in an Australian patient sample. Design: A longit udinal prospective study of a cohort of patients, with data collection at 3, 6, 9, and 12 months post injury. Setting: A head injury rehabil itation unit in a large metropolitan public hospital. Patients: A samp le of 55 patients selected from 120 consecutive admissions with severe TBI. Patients who were more than 3 months post injury on admission, w ho remained confused, or who had severe communication deficits or a pr evious neurologic disorder were excluded. Interventions: All subjects participated in a multidisciplinary inpatient rehabilitation program, followed by varied participation in outpatient rehabilitation and comm unity-based sen ices. Main Outcome Measures: The Sickness impact Profi le (SIP) provided physical, psychosocial, and total dysfunction scores at each follow-up. Outcome at 1 year was measured by the Disability R ating Scale. Results: Multivariate analysis of variance indicated that the linear trend of recovery over time was less for psychosocial dysf unction than for physical dysfunction (F(1,51) = 5.87, P < .02). One r ear post injury, 22% of subjects had returned to their previous level of employability, and 42% were able to live independently. Conclusions : Recovery from TBI in this Australian sample followed a pattern simil ar to that observed in other countries, with psychosocial dysfunction being more persistent. Self-report measures such as the SIP in TBI res earch are limited by problems of diminished self-awareness.