Prognostic Factors of Recovery and Discharge Outcome in Adults after Moderate Traumatic Brain Injury

Abstract

Abstract Background Traumatic brain injury (TBI) is a leading cause of mortality and morbidity particularly among young people. Identification of prognostic factors can be considerably helpful for clinical decision-making and prediction of outcome. Objective The aim of this study was to identify prognostic factors supposed to be of value in predicting functional outcome in moderate TBI patients. Materials and Methods This was a prospective case series study conducted from March 2023 to January 2024 involving 72 TBI patients with a Glasgow Coma Scale (GCS) score of 9 to 13. Demographic, clinical, laboratory, and management data were collected, analyzed, and correlated with patient outcomes. Based on the Extended Glasgow Outcome Scale (GOSE), patients were assigned to have either favorable outcome (GOSE score: 5–8) or poor outcome (GOSE score: 1–4). Results The mean age was 38.76 ± 18.30 years. The mean GCS score on admission was 11.68 ± 1.27. Surgical intervention was indicated in 29 patients (40.3%). The average length of hospital stay was 9.01 ± 7.88 days. Sixty-five patients (90.3%) had a favorable outcome and 7 patients (9.7%) had a poor outcome. Prognostic factors with significant impact on outcome included the GCS score on admission (p = 0.002); pupillary responses (p = 0.011); blood pressure (p = 0.005); acute subdural hematoma (ASDH) as a primary lesion (p = 0.049); and time to admission, comorbidities, blood glucose, hemoglobin%, oxygen saturation, coagulation profile, endotracheal intubation, and tracheostomy (p < 0.001). Conclusion In moderate TBI patients, delayed hospital arrival, low GCS score, unequal pupils, pretrauma comorbidities, hypotension, hypoxia, anemia, endotracheal intubation, tracheostomy, and ASDH were associated with unfavorable functional recovery and could be considered as poor prognostic factors.