Neuroanaesthesia & neurocritical care
Outcomes of Moderate-to-Severe Traumatic Brain Injury in a Low-Resource Setting
Authors' conclusion
In this cohort study of patients in Pakistan with msTBI, mortality was high, particularly among those with severe TBI, and most posthospital deaths occurred within the first month after hospital discharge. Older age, no surgical intervention, and greater injury severity were associated with higher mortality, highlighting the need for improved acute and postdischarge care in resource-limited settings.
Study context
- Population
- Adults (≥18 years) with moderate to severe TBI (GCS ≤12), trauma registry of 2 tertiary care centers in Karachi, Pakistan, 2021–2024158 lost to follow-up at 12 months
- Participants
- 819 adults
- Exposure
- Severe vs moderate TBI
- Moderate TBIn = 368reference
- Severe TBIn = 451
- Outcome
- Mortality (inpatient, follow-up, and cumulative)
Methodological detailsmulticentre registry
- Multicentre registry
Main finding
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Death within 1 month of discharge (patients discharged alive)
Cumulative mortality · 12 months
- Death within 1 month of discharge (patients discharged alive): 30 of 368 moderate; 26 of 451 severe
Factors associated with higher 12-month mortality
- Older age, per additional year
- aHR 1.01 (1.01-1.02) (95% CI)
- TBI severity
- aHR 2.67 (2.24-3.18) (95% CI)
- No surgical intervention
- aHR 1.43 (1.18-1.74) (95% CI)
Quality of life (QOL)
- Poor QOL across all domains in severe vs moderate TBI
Original publication
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