Long-term medical and psychosocial vulnerability after home return following severe traumatic brain injury.

OBJECTIVE

To identify a 5-year medical and psychosocial vulnerability profile among adults living at home 1 year after severe TBI and examine associated early characteristics.

DESIGN

Retrospective secondary analysis of a multicentre longitudinal cohort.

SUBJECTS/PATIENTS: Adults aged 16 years or older with operationally defined severe traumatic brain injury, private residence at 1 year, linked 5-year follow-up, and complete data for 4 profile indicators.

METHODS

Latent class analysis used 5-year rehospitalization, PHQ-9, GAD-7, and Satisfaction With Life Scale scores dichotomized with prespecified clinically interpretable thresholds. External rehabilitation outcomes and early associated factors were examined descriptively and with multivariable logistic regression.

RESULTS

Among 2,835 participants, a 2-class solution identified a lower-vulnerability profile (n = 2,361) and a multidomain vulnerability profile (n = 474). The latter showed more depressive symptoms, anxiety symptoms, low life satisfaction, and rehospitalization, with poorer 5-year functioning, participation, health, productive status, and higher frequency of non-private residence. Better 1-year global outcome was protective; female sex, preinjury illicit drug use, and living alone at 1 year were associated with assignment to this profile.

CONCLUSION

Home return after severe traumatic brain injury should be treated as a transition point for longitudinal rehabilitation surveillance.