New Study Suggests Higher Mortality Rate up to 5 Years After Moderate TBI Injury

By F.J. Thomas 

Sarasota, FL (WorkersCompensation.com) – When it comes to a traumatic brain injury (TBI), recovery is typically the most rapid within 3 to 6 months after injury. Some studies on moderate to severe TBIs have suggested that the most impressive function gains, including the ability to be independent again, can occur between 2 to 12 months post injury. 

While remarkable improvements may occur in the short term, long-term disabilities are very common after a TBI. Some studies have suggested that while the need for occupational and speech therapy may decrease over time, 1 in 6 patients with a TBI still require physical therapy at the 10 year mark. Additionally, an increased need for therapy services has been associated with more severe injuries, employment prior to the injury, and being a female. 

Even in cases of a mild TBI, patients are often plagued with issues. In fact, in one 2019 study, the researchers found that most patients with a mild TBI treated at level I trauma centers have persistent, injury related life difficulties within 1 year after injury. In cases of moderate-severe TBIs, outcomes have been varied, with patients returning to work but still rarely making a complete recovery. 

In a recent cohort study, researchers followed trauma patients with mild, or moderate-severe TBIs from 18 level I trauma centers in the U.S. between 2014 and 2018. The patients were enrolled in the study within 24 hours of injury, and then followed for 5 years. The goal of the study was to determine the course of functional, symptom, and quality of life outcomes for 1 to 5 years after the TBI. 

A total of 1,196 patients were included in the review. The average age for the study group was 40.8 years. Over half at 65 percent were male patients.   

Across both levels of severities, the researchers found potential for both continued functional improvement as well as persistently elevated rates of clinical impairment up to the end of the 5 year time period. While patients may have reached the ability to gain independence for doing tasks such as shopping, or managing their own transportation, there were many that still experienced symptoms, such as cognitive or physical limitations, that affected their daily lives. Around 83 percent of those with a moderate to severe TBI, and 53 percent of those with a mild TBI reported incomplete functional recovery at the 5 year mark. 

The researchers also concluded that moderate to severe TBI injuries were associated with a higher mortality rate. While it was unclear to the researchers what factors contributed to the increased death rate, other studies suggest that depression, physical comorbidities, cognitive functioning, quality of life, as well as access to rehabilitation and therapy support could be a contributor. 

Based on the results of the study, the researchers believe there is a most definite need for long-term support for TBI patients, as well as more study to determine the causes of increased mortality. 

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