Predicting Recovery After Mild TBI

Abstract

© Crown copyright 2019. INTRODUCTION: Mild Traumatic Brain Injury (MTBI) is often treated as a homogenous group in current practice. Stratifying patients more accurately may result in the implementation of more effective, individualized treatment. We aimed to identify prognostic indicators of recovery 1-yr following MTBI. METHODS: Using a prospective, observational study design, a large MTBI population (N = 596) was recruited following admission to the Emergency Department. Data was collected at brain injury clinics between August 2011 and July 2015. Functional recovery at 1-yr was assessed using the Glasgow Outcome Scale-Extended (GOSE). RESULTS: A follow-up rate of 92% was achieved. The most common aetiologies of MTBI were falls (n = 222) and road traffic collisions (n = 154). Distribution of Glasgow Coma Scale (GCS) was 15 (n = 363), 14 (n = 156) and 13 (n = 77). Multiordinal logistic regression of the GOSE found that psychiatric history (P < .001), alcohol intoxication (P = .011), assault (P = .022) and GCS <15 (P = < .001), led to worse outcome. An abnormal CT scan was not a predictor of functional recovery. CONCLUSION: Our findings indicate that after MTBI, patients with previous psychiatric history, GCS <15, aetiology of assault and alcohol intoxication result in worse long-term outcomes. Future work into developing a full prognostic model for MTBI may help to tailor individual treatment and improve long-term outcomes.