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Published on: February 16, 2011
Outcomes of Moderate-to-Severe Traumatic Brain Injury in a Low-Resource Setting
Kantesh Kumar1, Simran Motwani1, Komal Abdul Rahim1
1Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan.
JAMA Network Open
|August 11, 2026
Summary
Mortality after moderate to severe traumatic brain injury (msTBI) is high in low-income countries, especially for severe cases. Most deaths occur within a month post-discharge, linked to older age and lack of surgery.
Area of Science:
- Neuroscience
- Public Health
- Trauma Surgery
Background:
- Moderate to severe traumatic brain injury (msTBI) poses a significant global health challenge.
- Limited data exists on long-term outcomes, including mortality and quality of life (QOL), for msTBI patients in low- and middle-income countries (LMICs).
Purpose of the Study:
- To assess short- and long-term mortality and QOL in msTBI patients within an LMIC.
- To identify factors associated with mortality and QOL outcomes after msTBI.
Main Methods:
- A prospective cohort study was conducted with 819 adult msTBI patients in Karachi, Pakistan, from December 2021 to May 2024.
- Data on mortality and QOL were collected at 1, 3, 6, and 12 months post-injury.
- Statistical analysis identified factors associated with 12-month mortality.
Main Results:
- The 12-month cumulative mortality rate was 59.4% for moderate TBI and 87.8% for severe TBI.
- Inpatient mortality was 22.9% (moderate) and 68.9% (severe).
- Older age, TBI severity, and lack of surgical intervention were significant predictors of higher mortality. Severe TBI patients reported poorer QOL.
Conclusions:
- Mortality following msTBI in this LMIC setting is alarmingly high, particularly for severe injuries.
- A substantial proportion of deaths occurred within the first month after hospital discharge.
- Findings underscore the critical need for enhanced acute and post-discharge care strategies in resource-limited settings.
