Citation

Wilkins T, Beers SR, Hricik AJ, Brooks J, Mesley M, Puffer R, Chang Y, Okonkwo DO, Puccio AM. J. Neurotrauma 2019; ePub(ePub): ePub.

Affiliation

University of Pittsburgh Department of Neurological Surgery, 189496, Department of Neurosurgery, Pittsburgh, Pennsylvania, United States ; puccioAM@upmc.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.6153

PMID

31210093

Abstract

Favorable long-term functional outcomes after severe traumatic brain injury (TBI) may be under-estimated. We analyzed 24-month functional outcomes from a consecutive series of severe TBI survivors. A prospective, observational database of severe TBI survivors from a single institution was analyzed. Glasgow Outcome Scale-Extended (GOS-E) scores were obtained at 3-, 6-, 12-, and 24-months post-injury. GOS-E scores were dichotomized into unfavorable and favorable outcomes, and the proportion of survivors changing from unfavorable to favorable outcomes was calculated using Wilcoxon signed rank tests. Surviving adults (N=304; mean age ± SD = 35.06 ± 15.11; 80.92% male; mode of initial GCS = 7) were analyzed. A statistically significant mean increase in GOS-E was noted from 3 to 6 months, 6 to 12 months, 12 to 24 months, and 6 to 24 months after injury (0.65 (p-value<.0001), 0.42 (p-value<.0001), 0.23 (p-value=0.020), and 0.61 (p-value<.0001); respectively). Moreover, 43% of survivors from 3 to 6 months, 36% from 6 to 12 months, 38% from 12 to 24 months, and 54% from 6 to 24 months progressed from an unfavorable to a favorable outcome. Two-thirds of survivors in the unfavorable category at 3 months had favorable outcomes at two years. Overall 74% of surviving adults with a documented GOS-E at 2 years following injury had a favorable outcome. Severe TBI survivors demonstrated significant improvement in functional outcomes from 3 to 24 months following injury. At 2 years, three-fourths of survivors had a favorable outcome. Long-term prognosis in severe TBI is better than broadly appreciated.

Language: en

Keywords

ADULT BRAIN INJURY; HEAD TRAUMA; TRAUMATIC BRAIN INJURY