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.
Keywords
functional recovery - head trauma - moderate traumatic brain injury - outcome - prognostic
factors
