"It's not only the injury but also the kind of head." Factors influencing outcome after traumatic brain injury.
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Abstract summary
Given the high variability in TBI outcomes and relative lack of examination of influence of non-injury factors on outcome, this study aimed to examine factors associated with functional outcome at one and two -years after moderate-severe traumatic brain injury, including both pre-injury and injury-related factors.Observational cohort study.Inpatient hospital recruitment with outpatient follow-up at one- and two-years post-injury.Individuals with moderate to severe TBI were recruited prospectively into a Longitudinal Head Injury Outcome Study. 1899 participants consented to the study of the 3253 who were eligible.Functional outcome was measured using the Glasgow Outcome Scale - Extended.1476 participants (73.6% males) and 1365 participants (73% males) completed the Glasgow Outcome Scale - Extended at one- and two-years post-injury. They had a mean age at injury of 40 years and mean duration of post-traumatic amnesia of 26 days. Good recovery, representing return to previous activities on the Glasgow Outcome Scale - Extended (Score 7-8), was present in 31% of participants at one year post-injury and 33.5% at two years post-injury. When predictor variables were entered into regression together, good outcome was significantly associated with: not being from a culturally and linguistically diverse background and not having pre-injury mental health or alcohol treatment, shorter post-traumatic amnesia duration and absence of limb injuries at both one and two years, with higher education also a significant predictor at one year post-injury.Alongside consideration of injury severity, consideration of pre-injury factors is important to inform prognostication and rehabilitation planning.Study Outcome
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Doi : S0003-9993(24)00884-0SSN : 1532-821X