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Disability in young people and adults one year after head injury: prospective cohort study

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7250.1631 (Published 17 June 2000) Cite this as: BMJ 2000;320:1631
  1. Sharon Thornhill, research assistanta,
  2. Graham M Teasdale, professor (y.mitchell{at}clinmed.gla.ac.uk)a,
  3. Gordon D Murray, professor of medical statisticsb,
  4. James McEwen, professor of public healthc,
  5. Christopher W Roy, consultant in rehabilitation medicined,
  6. Kay I Penny, research fellowe
  1. a Department of Neurosurgery, University of Glasgow, Southern General NHS Trust, Glasgow G51 4TF
  2. b Department of Community Health Sciences, University of Edinburgh, Edinburgh EH8 9AG
  3. c University of Glasgow, Glasgow G12 8QQ
  4. d Southern General NHS Trust, Glasgow G51 4TF
  5. e Department of Community Health Sciences, University of Edinburgh
  1. Correspondence to: G M Teasdale
  • Accepted 15 March 2000

Abstract

Objective: To determine the frequency of disability in young people and adults admitted to hospital with a head injury and to estimate the annual incidence in the community.

Design: Prospective, hospital based cohort study, with one year follow up of sample stratified by coma score.

Setting: Five acute hospitals in Glasgow.

Subjects: 2962 patients (aged 14 years or more) with head injury; 549 (71%) of the 769 patients selected for follow up participated.

Main outcome measures: Glasgow outcome scale and problem orientated questionnaire.

Results: Survival with moderate or severe disability was common after mild head injury (47%, 95% confidence interval 42% to 52%) and similar to that after moderate (45%, 35% to 56%) or severe injury (48%, 36% to 60%). By extrapolation from the population identified (90% of whom had mild injuries), it was estimated that annually in Glasgow (population 909 498) 1400 young people and adults are still disabled one year after head injury.

Conclusion: The incidence of disability in young people and adults admitted with a head injury is higher than expected. This reflects the high rate of sequelae previously unrecognised in the large number of patients admitted to hospital with an apparently mild head injury.

Footnotes

  • Funding The study was supported by the chief scientist, Scottish Health Department (grant reference No K/OPR/2/2/D229)

  • Competing interests GMT has been reimbursed by government and professional scientific bodies and commercial organisations for attending scientific symposiums. Other research into head injuries by his department has been supported by the Scottish Health Department, the Medical Research Council, and Bayer, Novartis, Parke-Davies, and Cambridge Neuroscience. The University of Glasgow has received fees on GMT's behalf for advice and consultancy work to the foregoing bodies and Pharmos, SmithKline Beecham, GlaxoWellcome, and Pfizer, and for providing reports on medicolegal cases. GMT is director of three charitable organisations: the Head Injury Trust, Scotland; the European Brain Injury Consortium; and the International Neurotrauma Society

  • Embedded Image Additional tables and the problem orientated questionnaire appear on the BMJ's website

  • Accepted 15 March 2000
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