Long-term follow-up of functioning and life satisfaction after moderate to severe TBI – an exploratory cohort study

Objective: To examine the long-term outcomes after moderate to severe traumatic brain injury with diffuse axonal injury. Design: A follow-up study of a regional cohort with a mean follow-up period of 5 years post-injury. Subjects: Thirty-four participants were recruited from a regional neurointensive care unit. Inclusion criteria were age 16-65 years, a Glasgow Coma Scale score of 3-12, and radiologically confirmed diffuse axonal injury. Methods: Follow-up assessments conducted at least 1 year post-injury included global outcome measured by the Glasgow Outcome Scale Extended, activities of daily living assessed with the Barthel Index, and life satisfaction evaluated using the LiSat checklist. Results: More than two-thirds of participants regained independence, and approximately half returned to work or studies. A higher diffuse axonal injury stage was associated with a lower likelihood of returning to work or studies. Over half of respondents reported being satisfied or very satisfied with "life as a whole." Return to work or study was significantly associated with life satisfaction, and there was a trend toward higher satisfaction among those living with a partner. Conclusion: These findings confirm and extend observations from previous studies, emphasizing key areas for rehabilitation and long-term outcome after moderate to severe traumatic brain injury with diffuse axonal injury.