Long-Term Mortality and Quality of Life Among Adults With Mild Traumatic Brain Injury

Area of Science:

• Neuroscience
• Public Health
• Trauma Care

Background:

• Mild traumatic brain injuries (mTBIs) are a significant global health issue, causing substantial disability annually.
• These injuries disproportionately affect low- and middle-income countries (LMICs), with 90% of TBIs occurring in these regions.
• Understanding long-term outcomes of mTBI in LMICs is crucial for effective healthcare planning.

Purpose of the Study:

• To assess the 12-month mortality, quality of life (QoL), and functional status of patients with mTBI in Pakistan.
• To identify factors influencing long-term outcomes in a Pakistani mTBI cohort.
• To provide data on mTBI recovery in a resource-limited setting.

Main Methods:

• A prospective cohort study analyzed data from 602 adult patients with mTBI (GCS 13-15) admitted to two tertiary care centers in Karachi, Pakistan.
• Patients were followed up for 12 months, with outcomes recorded at 1, 3, 6, and 12 months.
• Primary outcomes included 12-month mortality; secondary outcomes included QoL and functional status.

Main Results:

• The 12-month mortality rate was 13.6%. Patients with a GCS score of 13 or 14 had approximately double the 12-month mortality compared to those with a GCS score of 15.
• Surgical intervention was associated with a 51% reduction in 1-month mortality.
• By 1 year, 78% of patients achieved complete independence, though physical well-being recovery was lower, particularly in those with lower GCS scores.

Conclusions:

• Lower GCS scores (13-14) in mTBI patients are associated with significantly higher 12-month mortality and poorer long-term quality of life in Pakistan.
• While many patients achieve functional independence, physical disability persists, especially in those with initially lower GCS.
• Findings underscore the importance of Glasgow Coma Scale scores in predicting long-term mTBI outcomes and the need for continued monitoring and support in LMICs.