Functional Outcomes Over the First Year After Moderate to Severe Traumatic Brain Injury in the Prospective,...

Area of Science:

• Neuroscience
• Trauma Surgery
• Rehabilitation Medicine

Background:

• Moderate to severe traumatic brain injury (msTBI) is a leading cause of death and disability globally.
• Prospective, longitudinal outcome data collection from acute to chronic phases after msTBI is limited.

Purpose of the Study:

• To prospectively assess functional outcomes at 2 weeks and 3, 6, and 12 months post-msTBI.
• To evaluate the trajectory of recovery and factors influencing outcomes in msTBI patients.

Main Methods:

• A prospective, longitudinal cohort study (TRACK-TBI) involving 484 patients with msTBI (Glasgow Coma Scale scores 3-12) across 18 US trauma centers.
• Functional status assessed using the Glasgow Outcome Scale-Extended (GOSE) and Disability Rating Scale (DRS) at multiple time points.
• Neurocognitive testing and patient-reported outcomes analyzed at 12 months post-injury.

Main Results:

• Significant functional gains were observed between 2 weeks and 12 months post-msTBI.
• By 12 months, 52.4% of severe TBI and 75% of moderate TBI patients achieved favorable GOSE outcomes.
• 19.3% of severe TBI and 32% of moderate TBI patients reported no disability (DRS score 0) at 12 months.
• Among those in a vegetative state at 2 weeks, 78% regained consciousness and 25% regained orientation by 12 months.

Conclusions:

• Patients with msTBI frequently demonstrate substantial functional recovery and independence gains up to 12 months post-injury.
• Short-term severe impairment does not preclude favorable long-term outcomes in a significant proportion of msTBI patients.
• Clinicians should exercise caution against making definitive early prognostic statements within the first two weeks post-msTBI.