{Reference Type}: Journal Article
{Title}: Post Discharge Six-Month Functional Recovery of Traumatic Brain Injury Survivors with Unfavorable Functional Status at Discharge: A Registry-Based Cohort Study.
{Author}: Zoghi S;Ansari A;Niakan A;Taheri R;Khalili H;
{Journal}: World Neurosurg
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 25
{Factor}: 2.21
{DOI}: 10.1016/j.wneu.2024.06.116
{Abstract}: BACKGROUND: Traumatic Brain Injury (TBI) is a major cause of physical disabilities worldwide. Herein, we aimed to investigate the factors contributing to post-discharge recovery in patients who were discharged with an unfavorable outcome.
METHODS: We collected data on the characteristics of patients, with a focus on those who survived TBI but had an unfavorable outcome at discharge as measured by Glasgow Outcome Scale Extended; GOSE categories two, three, and four. Post-discharge recovery was defined as achieving a favorable functional status at six months (GOSE of five or more) with a minimum two-point increase in GOSE.
RESULTS: Of 4011 TBI patients in our registry, 797 had an unfavorable discharge functional status. In severe TBI, 51% achieved recovery, while in mild to moderate TBI, 57% achieved recovery after six months. Older patients and those with shorter intensive care unit length of stay were more likely to experience post-discharge recovery in both mild to moderate and severe TBI groups. The presence of base of skull fracture was also associated with post-discharge recovery in severe TBI patients. Lastly, we showed that, after adjustment for potential confounders, GOSE at discharge is associated with post-discharge recovery in both mild to moderate and severe TBI patients.
CONCLUSIONS: This study found that the majority of the patients who were discharged with an unfavorable functional status were able to achieve a favorable outcome within six months. The novel post-discharge recovery in TBI patients might be a useful toll for illuminating the factors associated with a significant improvement after discharge.