Functional outcome at 1 year following moderate to severe traumatic brain injury

Abstract

Traumatic brain injury (TBI) is a leading cause of disability among young adults population in Malaysia. The multi-cultural background and limited post-injury rehabilitation services in Malaysia may play a role in the long-term outcome. This research aimed to describe the functional outcome of moderate to severe TBI patients at one year post-injury. A prospective cohort study was conducted at University Malaya Medical Centre (UMMC), a tertiary referral center with availability of an early inpatient rehabilitation after TBI. Patients with moderate to severe TBI were selected via a universal sampling method. The functional outcome was assessed at 1 year post-injury using Glasgow Outcome Scale-Extended (GOSE). Factors associated with good outcome (GOSE score of 7&8) were analysed via regression analysis. A total of 100 patients were included in this study. The mean age of the study population was 39.4 ( ± 17.6) years old. Majority of participants were male (87%), less than 40 years old (57%) and involved in a motor vehicle accident (77%). 25% of patients have good outcome at 1 year. Factors significantly affecting the functional outcome were age, premorbid marital status, education level, presence of concomitant extremity fractures and early inpatient rehabilitation. After adjusting for the confounders, absence of concomitant extremity fractures was found to be a significant predictor for good functional outcome at one year (OR 9.26, 95% CI 1.86–46.12, P = 0.007) Good functional outcome at one year following moderate to severe TBI is slightly lower than other Western studies. However, factors influencing good outcome is comparable to literature worldwide. Early inpatient rehabilitation should be provided as it can improve the functional outcome. Since concomitant extremity fractures significantly influenced outcome post TBI, it is very important to treat the fractures early and aggressively so that patients can start intensive rehabilitation earlier.