@article {Brett10.1212 / WNL。0000000000207501,作者={本杰明L布雷特和南希Temkin细语和杰森·k·巴伯和大卫·o·莫里斯坦和叶莲娜G Bodien约翰·克里甘和雷蒙Diaz-Arrastia和约瑟夫·t·吉亚奎洛以及迈克尔·麦克雷博士和杰弗里·t·曼利和林赛·尼尔森和TRACK-TBI调查员},title ={创伤性脑损伤后长期的多域模式变化:TRACK-TBI长研究},elocation-id = {10.1212 / WNL。={2023}0000000000207501},年,doi = {10.1212 / WNL。出版商0000000000207501}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景:创伤性脑损伤(TBI)可能是一个慢性疾病携带风险为未来的后遗症;半岛投注体育官网一些前瞻性研究具有抑制受损的结果。延伸检查长期我们检查的功能、认知和精神变化结果具有抑制受损。延伸从1 {\ textendash} 7年方法:TRACK-TBI长参与者前瞻性的24小时内损伤具有抑制受损;延伸,之后1年参加一个子集具有抑制受损。延伸长期随访2 - 7日年可靠的短暂变化阈值测试成人认知通过电话一般复合(认知)和短暂的症状Inventory-18(精神)来自骨科创伤控制(各位)。具有抑制受损基线评估和延伸多个评估完成后(两个或三个访问具有抑制受损)延伸2 - 7年在样本子集。变化是评估功能结果(格拉斯哥结果Scale-Extended[戈斯])和自我/线人报告下降。 Prevalence ratios for outcomes classified as stable, improved, declined were reported individually and collectively. Fisher{\textquoteright}s-exact test and log-binomial regression models examined factors associated with decline and improvement.Results: Of the sample (N=1264; mild TBI, GCS 13-15 [mTBI] n=917, moderate-severe TBI GCS 3-12 [msTBI] n=193, or OTC n=154), {\textquoteleft}stable{\textquoteright} was the most prevalent outcome. Functional outcome showed the highest rates of decline, regardless of TBI severity (mild=29\%; moderate/severe=23\%). When measures were considered collectively, rates of decline included mTBI(21\%), msTBI(26\%), OTC(15\%). Age and pre-injury employment status were associated with functional decline (per 10-years; RR=1.16[95\% CI=1.07, 1.25], p\<.001; higher in retired/disabled/not working vs. full-time/part-time; RR=1.81[1.33, 2.45], respectively) in the mTBI group. Improvement in functional recovery 2-7 years post-injury was associated with higher BSI scores (per 5 points; RR=1.11[1.04, 1.18], p=.002) and GOSE score of 5-7 (GOSE=8 as reference; RR=2.64[1.75, 3.97], p\<.001). Higher BSI scores and identifying as Black (RR=2.28[1.59, 3.25], p\<.001) was associated with greater likelihood of improved psychiatric symptoms in mTBI (RR=1.21[1.14, 1.29], p\<.001). Greater likelihood of cognitive improvement was observed among those with higher educational attainment in msTBI (per 4-years; RR=2.61[1.43, 4.79], p=.002).Conclusions and Relevance: Function across domains at 1-year post-injury, a common recovery benchmark, undergo change across the subsequent 6-years. Results support consideration of TBI as a chronic, evolving condition and suggest continued monitoring, rehabilitation, and support is required to optimize long-term independence and quality of life.}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/early/2023/06/21/WNL.0000000000207501}, eprint = {//www.ebmtp.com/content/early/2023/06/21/WNL.0000000000207501.full.pdf}, journal = {Neurology} }