Functional outcome at one year following moderate to severe traumatic brain injury: A prospective study in Malaysia

Background & Objective: Traumatic brain injury (TBI) is a leading cause of disability among young adult population. Those with more severe TBI continue to experience long term disability. This research aimed to describe the functional outcome of moderate to severe TBI patients at one year post-injury in a Malaysian setting. Methods: This was a prospective cohort study conducted at University Malaya Medical Centre (UMMC) involving 100 patients who were admitted with moderate to severe TBI. The functional outcome was assessed at one year post injury using Glasgow Outcome Scale-Extended (GOSE). Factors associated with good outcome were analysed via regression analysis. Results: The mean age of the study participants was 39.4 (+/- 17.6). Majority of participants were male, less than 40 years old and involved in a motor vehicle accident. Good outcome (GOSE score of 7 & 8) at one year was reported in 25% of the patients. Factors significantly affecting functional outcome were age, premorbid marital status, education level, presence of concomitant extremity fractures and early inpatient rehabilitation (p <0.05). After adjusting for the confounding factors, 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) Conclusion: Good functional outcome at one year following moderate to severe TBI in our population is lower than other studies worldwide. However, factors influencing good outcome at one year is comparable to other developed countries. Early management of concomitant extremity fractures may allow patients to participate in early inpatient rehabilitation for a better outcome.