A Comparison of Satisfaction With Life and the Glasgow Outcome Scale-Extended After Traumatic Brain Injury: An Analysis of the TRACK-TBI Pilot Study.
Natalie P Kreitzer, Kimberly Hart, Christopher J Lindsell and 5 others
PMID 30499935WHAT IT FOUND
Six months after TBI, 31% had a mismatch between functional recovery and life satisfaction.
Depression at six months was linked to lower satisfaction. Ask about mood, not just recovery.
Key findings
01At six months, GOSE and SWLS had a correlation of 0.380, and 93 of 298 patients were discordant.
02Depression at six months had a negative correlation with SWLS of -0.656, and history of depression, depression at six months, and TBI severity were independently associated with discordance.
03Males with a past history of depression had the most significant discordance, meaning highest likelihood of good recovery with impaired satisfaction, followed by mild TBI.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Patients included in the analysis were slightly more likely to be better educated and employed before injury than patients not included, which may bias satisfaction results upward. Depression and satisfaction were measured at the same six-month visit, so the study cannot show that depression caused lower satisfaction. The study used only variables available in the database, so other factors such as chronic pain, sleep disorders, or PTSD may explain part of the mismatch. Prior depression was identified by self-report or medical record review, so past and current depression and diagnosed versus self-reported depression could not be separated. Moderate and severe TBI cases were less frequent, and patients with more severe cognitive deficits may respond differently to these outcome measures. The GOSE may not fully capture mild disability, because GOSE 7 and 8 can differ on other outcome measures.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read a good functional outcome as proof of good life satisfaction. The GOSE and SWLS correlation was 0.380, and 93 patients were discordant, so good recovery can coexist with impaired satisfaction.