Original research| Volume 99, ISSUE 8, P1576-1583, August 2018

Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury

Published:March 12, 2018DOI:


      • Twelve-month prospect cohort study of 188 patients with severe TBI.
      • First investigation of postinjury relation between PTS and HRQoL.
      • PTS associated with mental but not physical HRQoL post-TBI.
      • PTS associated with interpersonal and cognitive functioning post-TBI.
      • PTS associated with total and emotional functioning if patients ≤50 years of age.



      To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI).


      Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011).


      Hospital, rehabilitation unit, and/or patient’s living facility.


      Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan.


      Not applicable.

      Main Outcome Measures

      HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation).


      Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and P=.002), respectively. Among patients ≤50 years of age, PTS symptom severity was significantly associated with total functioning (P=.001) and emotional functioning (P<.001). Among all patients, PTS symptom severity was significantly associated with cognitive functioning (P<.001) and mental HRQoL (P=.01).


      Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning.


      List of abbreviations:

      DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition), GCS (Glasgow Coma Scale), HAIS (Abbreviated Injury Scale of the head region), HRQoL (health-related quality of life), MCS (Mental Component Summary), PCS (Physical Component Summary), PCRS-NR (Patient Competency Rating Scale for Neurorehabilitation), PEBITA TRAST-MI (Patient-relevant Endpoints after Brain Injury from Traumatic Accidents Trajectories of Recovery After Severe TBI - Matter in Families), PTS (posttraumatic stress), PTSD (posttraumatic stress disorder), SF-12 (Medical Outcomes Study 12-Item Short-Form Health Survey), TBI (traumatic brain injury)
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