“Can differences in hospitalised mild traumatic brain injury (mTBI) outcomes at 12 months be predicted?”

Objectives To identify risk factors for poor outcome one year post-mild traumatic brain injury (mTBI). Design This study was a prospective observational study using consecutive adult hospital admissions with mTBI. Subjects A total of 869 consecutive mTBI patients were enrolled in this study. Methods All patients were reviewed by the specialist TBI rehabilitation team at six weeks and one year following mTBI. Demographic and injury data collected included: age, gender, TBI severity and Glasgow Coma Scale (GCS). At twelve months, global outcome was assessed by the Extended Glasgow Outcome Score (GOSE) and participation restriction by the Rivermead Head Injury Follow-up Questionnaire (RHFUQ) via semi-structured interview. An ordinal regression (OR) was used to identify associated factors for poor GOSE outcome and a linear regression for a poor RHFUQ outcome. Results In the GOSE analysis, lower GCS ( p < 0.001), medical comorbidity ( p = 0.027), depression ( p < 0.001) and male gender ( p = 0.008) were identified as risk factors for poor outcome. The RHFUQ analysis identified: lower GCS ( p = 0.002), female gender ( p = 0.001) and injuries from assault ( p = 0.003) were variables associated with worse social functioning at one year. Conclusion mTBI is associated with a significant impact upon the physical health and psychosocial function of affected individuals. The results of this study demonstrate that differences in mTBI outcome can be identified at twelve months post-mTBI and that certain features, particularly GCS, are associated with poorer outcomes.