TBI, remains a growing public health concern and represents the major contributor to death and disability globally among all trauma-related injuries and also known as the silent epidemic.1,2,3 According to estimates based on literature reported numbers1,2,3, about 50–60 million individuals are affected by TBI each year, and it is predicted that close to 50% of the world’s population will sustain a TBI in their lifetime.9
Patients with mild, moderate or severe brain injuries suffer from physical, cognitive, behavioural, emotional and social problems, however specific instruments or objective assessment to evaluate quality of life in patients with TBI is scarce.10 In Indonesia particularly, the information regarding the quality of life in patients with TBI is severely lacking, hence creating a gap for policy making and public health intervention.
In this study, we investigated the quality of patients with TBI and compared the findings with similar clinical characteristics from non-TBI patients. We found that patients with TBI had a tendency to die at a younger age than non-TBI patients, although it did not reach statistical significance. This finding reflect the condition in our region that majority of patients with TBI were young adults and male. These population are at high risk for having TBI due to highly mobile and lack of road safety awareness.11,12
In this study, we found that mortality commonly observed in patients with lower GCS either in patients with TBI and non-TBI. This finding in accordance to literatures, suggesting initial GCS value reflects the state of brain damaged or neurological insults. Low GCS value is associated with dismal prognosis.13,14
We found that at 3 months of follow up, patients with TBI were more frequent to have impairment in mobility and self-care than non-TBI patients. This finding indicate that the social burden of TBI might be underestimated. Impairment in mobility and self-care in patients with TBI, particularly in young adults significantly decrease the productivity, hence creating a socioeconomic burden for the society.15 Previous study in European community, indicated the quality of life of patients with TBI is better than non-TBI, as indicated by better performance in cognitive function and daily tasks.16 On this matter, cultural differences might have influenced the findings,17 in our society the attention regarding TBI is severely lacking, hence public awareness of its sequel is low.13,14. Nevertheless, there was a trend of quality of life improvement in patients with TBI during the follow-up. Appropriate managed-care could enhance the recovery and promote better quality of life hence reducing socioeconomic burden for the society.
This finding in this study could be used for the reference for the policy making and health care intervention in Indonesia. Further study involving more participants and nationwide would be pivotal to confirm the findings in this study.