Recent study finds incomplete recovery at 5 years in 53% of mTBI patients
A large TRACK-TBI cohort study published in JAMA Network Open finds incomplete recovery at 5 years in 53% of mild traumatic brain injury (mTBI) patients, dictating need for longer term rehabilitation.
A multi-center transforming research and clinical knowledge in TBI (TRACK-TBI) cohort study published March 20, 2023 in JAMA Network Open followed 1196 patients at 18 level 1.0 trauma care centers in the US over five years, including patient with mTBI, patients with moderate-severe brain injury (msTBI) and orthopedic controls. It found persistently elevated rates of incomplete functional outcomes in 53% of mild traumatic brain injury patients and 83% of msTBI patients compared to controls, supporting a need for longer term monitoring and rehabilitation.
Clinical recovery from TBI typically proceeds most rapidly in the first 3-6 months post injury. Consequently, most studies have terminated follow up by 6 months resulting in limited data on TBI’s long-term natural history. As the authors note, this limited data has led to the “clinical narrative that recovery is unidirectional (i.e. improving) and time-limited.” The current study reinforces other smaller retrospective studies countering this clinical narrative and demonstrating a need for ongoing support for many patients beyond the first few months post injury. “Our findings justify intensifying efforts to provide longer-term rehabilitation, mental health treatment, and community services for persons with TBI.”
The study also revealed several social determinants of long-term TBI outcome. Less favorable outcomes were found in patients who were older, female and who had less baseline education. Lack of good health insurance and a history of prior TBIs were also predictive. The authors encourage further study of the biological mechanisms by which age and gender affect TBI recovery, which could fuel more effective treatments.