Functional outcome in traumatic brain injury in Tunisia

Introduction Traumatic brain injury (TBI) occurs mainly in young adults in full swing. The objective of this work is to specify the functional outcome of patients with TBI sequelae. Methods We included adult patients who were hospitalised between January 2009 and December 2013 for the management of TBI sequelae. We excluded patients with a history of neurological or psychiatric disorders before the TBI. We contacted these patients in an attempt to clarify their current functional status. For each patient we stated: the functional independence measurement (FIM), the severity of disability based on the Glasgow Outcome Scale (GOS). The motor part of the Canadian neurological scale was used to evaluate motor impairments. Results 27 patients were included. 89.3% of our patients were male. The mean age was 34.6 (range: 19 to 66 years). The TBI was severe in 19 cases and moderate in 8 patients. The average duration of post-traumatic coma was 38.7 days. Initial FIM was 66.4/126. The overall assessment of disability by the GOS found two vegetative states; 9 patients had moderate disability and 16 patients had severe disability. A motor impairment was found in all these patients. Only one patient had resumed his previous occupation; 2 had resumed a professional activity with adaptation of the workplace; and 3 others were following appropriate training. Conclusion The socio-professional reintegration remains a difficult goal to achieve, due to neuropsychological disorders in addition to orthopaedic sequelae which often causes neuro dependency and disability. However, it should optimise the residual functional capacity whenever the possibility of a life plan is offered to the patient.