A new study published in JAMA Neurology further debunks the myth often heard by defense doctors in litigation: everyone recovers from an mTBI within 6 to 8 weeks.
The study compared the persistent, injury-related functional limitations following mild traumatic brain injuries to those following orthopedic traumas.
The researchers concluded “most patients with mTBI presenting to US level I trauma centers report persistent, injury-related life difficulties at 1 year post injury.” This suggests the need for more systematic follow-ups for patients with mTBI to reduce the risk of chronic issues.
The study examined a total of 1453 patients at 11 level I trauma center emergency departments or inpatient units who met inclusion criteria (ie, mTBI [n = 1154] or peripheral orthopedic traumatic injury [n = 299]). All participants were enrolled in the study within 24 hours of injury. mTBI participants had admission GCS scores of 13 to 15 and clinical head CT scans. Patients with peripheral orthopedic trauma injury served as the control (OTC) group.
Of the 1453 participants, 953 (65.6%) were men; mean (SD) age was 40.9 (17.1) years in the mTBI group and 40.9 (15.4) years in the OTC group.
At two weeks post-injury, most participants (mTBI, 87%; OTC, 93%) reported functional limitations (GOSE <8).
At 12 months post-injury, the percentage of mTBI participants reporting functional limitations was 53% (95% CI, 49%-56%) while the OTC group's percentage was considerably lower, with 38% (95% CI, 30%-45%) still reporting functional limitations. A higher percentage of CT+ patients reported impairment (61%) compared with the mTBI CT− group (49%; relative risk [RR], 1.24; 95% CI, 1.08-1.43) and a higher percentage in the mTBI CT−group compared with the OTC group (RR, 1.28; 95% CI, 1.02-1.60).
- “Recovery After Mild Traumatic Brain Injury in Patients Presenting to US Level I Trauma Centers A Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study”, Lindsay D. Nelson, PhD; Nancy R. Temkin, PhD; Sureyya Dikmen, PhD; et al (JAMA Neurol. Published online June 3, 2019)