Risk Factors for Long-Term Health-Related Quality-of-Life and Mental Health Outcomes in Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

In 30 seconds

This systematic review and meta-analysis examined early risk factors for long-term mental health and health-related quality-of-life outcomes in adults with traumatic brain injury (TBI), using studies with outcomes assessed at least 6 months after discharge. Among 64 studies involving 334,672 participants, female sex, socioeconomic disadvantage, psychiatric history, assault-related injury, and previous TBI were consistently associated with poorer outcomes. For post-traumatic stress disorder, assault-related injury was associated with higher odds (OR = 2.72; 95% CI: 2.01-3.66, I² = 0%).

Key findings

• Assault-related injury was associated with higher odds of post-traumatic stress disorder (OR = 2.72; 95% CI: 2.01-3.66, I² = 0%).
• Higher odds of post-traumatic stress disorder were associated with female sex (OR = 1.33; 95% CI: 1.11-1.59, I² = 0%), prior TBI, and psychiatric history.
• Depression was associated with female sex (OR = 1.72; 95% CI: 1.38-2.16, I² = 58%), prior TBI (OR = 1.52; 95% CI: 1.25-1.85, I² = 0%), and psychiatric history (OR = 3.25; 95% CI: 1.86-5.69, I² = 98%).
• Higher pooled anxiety scores were observed among females and people with a psychiatric history.

Why it matters

The findings identify factors available before or by discharge that are associated with later mental health and quality-of-life difficulties. Such evidence may help inform risk-stratified follow-up and future prognostic tools, while the reported heterogeneity and observational associations mean these factors should not be interpreted as causes or definitive individual predictions.

What to keep in mind

The review reports that the underlying literature was sparse and methodologically heterogeneous, limiting clinical applicability; heterogeneity was substantial for some pooled associations.