Disability in young @entity1 and adults after XXXX : 5-7 year follow up of a prospective cohort study.

@entity1 @entity308 @entity73 @entity542 @entity458 @entity148 @entity130
BACKGROUND: Improvement 1-2 years after @entity542 is well established but the pattern thereafter is unclear. Past studies have not examined representative @entity542 populations and typically report findings in terms of functioning across social, @entity458 , or cognitive domains rather than global outcome. OBJECTIVE: To determine the late outcome of a representative cohort of @entity1 admitted to hospital after a @entity542 5-7 years previously and to identify early and late factors correlating with persisting disability and change between one and 5-7 years. METHODS: A representative cohort of head injured @entity1 whose outcome one year after @entity130 was reported previously, were followed up 5-7 years after @entity130 . @entity1 were assessed using structured and validated measures of global outcome (Glasgow Outcome Scale Extended), @entity73 , @entity458 , health status, and social factors. RESULTS: Of 475 survivors studied at one year, 115 (24%) had died by seven years. In survivors at 5-7 years, disability remained frequent (53%); and the rate, similar to that found at one year (57%). Sixty three @entity1 (29%) had improved but 55 (25%) deteriorated. The persistence of disability and its development after previous recovery each showed stronger associations with indices of @entity308 , @entity148 , and low self-esteem than with initial severity of @entity130 or persisting @entity73 . CONCLUSIONS: Admission to hospital after @entity542 is followed 5-7 years later by disability in a high proportion of survivors. Persistence of disability and development of new disability are strongly associated with psychosocial factors that may be open to remediation, even late after @entity130 .
