Acute Neuroimaging Findings Are Associated with Poor Outcome after Mild Traumatic Brain Injury: A Systematic Review...

Area of Science:

• Neuroscience
• Radiology
• Clinical Outcomes Research

Background:

• Mild traumatic brain injury (mTBI) is common, but predicting outcomes based on acute neuroimaging is challenging.
• Previous studies have yielded inconclusive results regarding the association between early neuroimaging abnormalities and mTBI prognosis.
• Identifying reliable indicators for poor outcomes after mTBI is crucial for patient management and resource allocation.

Purpose of the Study:

• To systematically review and meta-analyze existing literature to determine if acute neuroimaging findings after mTBI are associated with health outcomes, recovery, or injury severity.
• To quantify the association between acute neuroimaging findings and various outcome measures following mTBI.
• To assess the clinical relevance of acute neuroimaging findings in predicting outcomes after mild traumatic brain injury.

Main Methods:

• Systematic review and meta-analysis of studies published up to April 2024, searching MEDLINE, PsycINFO, and Web of Science.
• Inclusion of prospective studies or retrospective analyses of prospective data with CT scans within 1 week or MRI scans within 3 months of mTBI.
• Primary outcome: Glasgow Outcome Scale. Secondary outcomes: loss of consciousness, post-traumatic amnesia, and post-concussion symptoms. PRISMA guidelines followed.

Main Results:

• The presence of acute neuroimaging findings after mTBI was significantly associated with a higher odds of poor outcome (OR = 2.04) and loss of consciousness (OR = 1.42).
• No significant association was found between acute neuroimaging findings and post-traumatic amnesia (OR = 1.27) or post-concussion symptoms (Hedge's g = 0.00).
• Qualitative analysis supported the quantitative findings, indicating clinical relevance for risk stratification.

Conclusions:

• Acute neuroimaging findings following mild traumatic brain injury are associated with poorer functional outcomes.
• These findings are clinically relevant for identifying mTBI patients at increased risk of adverse outcomes.
• Further research may refine the prognostic value of specific neuroimaging abnormalities in mTBI.