Predicting functional recovery after mild traumatic brain injury: the SHEFBIT cohort

ABSTRACT

Background: Current prognostic models for mild Traumatic Brain Injury (mTBI) are unsatisfactory in identifying patients at risk of an unfavorable outcome following injury.

Objective: To identify prognostic indicators of recovery one-year following mTBI.

Methods: A large population (n = 596) of patients with mTBI were prospectively recruited following admission to the Emergency Department. Data were collected at brain injury clinics at 8–10 weeks and one-year after injury. Functional recovery at one year 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 GCS was 15 (n = 363), 14 (n = 156) and 13 (n = 77). Ordinal regression analysis found that psychiatric history (p < .001), alcohol intoxication (p = .011), assault (p = .022) and GCS < 15 (p =< 0.001), were associated with worse outcome. An abnormal CT scan was not a predictor of disability.

Conclusion: Patients with a previous psychiatric history, GCS < 15, etiology of assault, and alcohol intoxication result in worse long-term outcomes after mTBI. The predictors identified should be implemented when developing a future-validated a prognostic model for mTBI recovery.

KEYWORDS:

• Mild traumatic brain injury
• post-concussion symptoms
• prognosis
• recovery

Disclosure of interest

The authors report no conflict of interest.