Long-Term Outcomes in Severe Traumatic Brain Injury and Associated Factors: A Prospective Cohort Study

Abstract

Objective: The presence of focal lesion (FL) after a severe traumatic brain injury is an important factor in determining morbidity and mortality. Despite this relevance, few studies show the pattern of recovery of patients with severe traumatic brain injury (TBI) with FL within one year. The objective of this study was to identify the pattern of recovery, independence to perform activities of daily living (ADL), and factors associated with mortality and unfavorable outcome at six and twelve months after severe TBI with FL. Methodology: This is a prospective cohort, with data collected at admission, hospital discharge, three, six, and twelve months after TBI. RESULTS: The study included 131 adults with a mean age of 34.08 years. At twelve months, 39% of the participants died, 80% were functionally independent by the Glasgow Outcome Scale Extended, 79% by the Disability Rating Scale, 79% were independent for performing ADLs by the Katz Index, and 53.9% by the Lawton Scale. Report of alcohol intake, sedation time, length of stay in intensive care (ICU LOS), Glasgow Coma Scale, trauma severity indices, hyperglycemia, blood glucose, and infection were associated with death. At six and twelve months, tachypnea, age, ICU LOS, trauma severity indices, respiratory rate, multiple radiographic injuries, and cardiac rate were associated with dependence. Conclusions: Patients have satisfactory functional recovery up to twelve months after trauma, with an accentuated improvement in the first three months. Clinical and sociodemographic variables were associated with post-trauma outcomes. Almost all victims of severe TBI with focal lesions evolved to death or independence.

The Relationship between Injury Characteristics and Post-Traumatic Recovery after Diffuse Axonal Injury

“…A previous study conducted with 110 patients with consciousness disorders after moderate and severe TBI showed independence in carrying out self-care activities during the first five years after the injury [28]. A study conducted with 131 adults after severe TBI with focal lesions showed an improvement in independence to perform ADL and IADL over time, where approximately 79% of patients had independence in performing ADL at twelve months, while more than half, 54%, were independent in performing more complex activities such as managing finances, using the telephone, shopping, food preparation, and housekeeping [29]. In our study, at twelve months after DAI, 46.3% of patients had the maximum score on the Lawton Scale, indicating complete independence in performing IADL.…”

Risk of Migraine after Traumatic Brain Injury and Effects of Injury Management Levels and Treatment Modalities: A Nationwide Population-Based Cohort Study in Taiwan

“…We propose some possible explanations for these results. First, the follow-up times and methods for measuring tracking progress after TBI differed in the studies [ 48 ]. A recent study revealed that most patients improve within a few days to a few weeks; however, many patients continue to report PCS for months or years, even after very minor head injuries [ 49 ].…”

A Study Of Severe Traumatic Brain Injury At A Tertiary Care Center

“…In a prospective cohort study by Oliveira et al ( 2022) involving individuals with severe TBI and focal lesions, it was found that significant functional recovery occurred in the first twelve months after the injury, with the most pronounced improvements observed within the initial three months. This underscores the potential for substantial long-term recovery in severe TBI patients [19]. Through a thorough examination of the current corpus of literature pertaining to long-term outcomes subsequent to severe "Traumatic brain injury (TBI)", the review uncovered a wide range of findings.…”