Research Reports - Concomitant injuries and its influence on functional outcome after traumatic brain injury

Disabil Rehabil. 2013 Aug;35(18):1546-51

Leong BK, Mazlan M, Rahim RB, Ganesan D

This study aims to describe the presence and severity of
extracranial concomitant injuries in traumatic brain injury (TBI) patients and to
ascertain their effect on long-term functional outcome. Method: A retrospective
cohort study was performed in a single-center recruiting patients with first
episode of TBI. The types and severity of extracranial concomitant injuries were
documented for patients who fulfilled the inclusion criteria. Injuries with
Abbreviated Injury Scale (AIS) grade 3-6 were considered to be high grade. A
cross-sectional functional assessment was conducted at 18 months post-injury
using Glasgow Outcome Scale. Results: A total of 100 patients were included in
the analysis. Extracranial concomitant injuries were seen in 78% of the patients.
Three commonest injuries were facial (44%), lower extremity (20%) and upper
extremity (12%) injuries. Among the AIS grade ≥ 3, injury involving the chest was
most common (41%). Presence of extracranial concomitant injuries AIS grade ≥ 3
was significantly associated with disability in TBI patients at 18 months (OR
12.74, 95% CI 2.39-67.95, p = 0.003). Conclusion: Presence of extracranial
concomitant injuries was high. In TBI survivors, extracranial concomitant
injuries AIS grade ≥ 3 influenced the long-term functional outcome at 18 months,
causing moderate and severe disabilities. Implications for Rehabilitation
Concomitant injuries should be suspected in patients with traumatic brain injury,
especially in a high-speed trauma mechanisms as the incidence can be as high as
78% as in this study and may interfere with the long term rehabilitation and
outcome. This study shows that severe extra cranial concomitant injuries are
associated with a poor long term functional outcome even in the mild traumatic
brain injury patients and therefore need to be addressed early in the
rehabilitation of this group of patients. Early diagnosis and management of
severe concomitant injuries is warranted and may improve the functional gains in
the long term after traumatic brain injury.

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