Critical CareIntensive CareNeuroTraumaBrain injury outcomes and predictors

Brain injury outcomes and predictors by Kiran Lele

Being able to prognosticate in the aftermath of a traumatic brain injury (TBI) is important as it assists with counselling patients and families. Moreover, it helps rationally allocate healthcare resources.

However, due to the heterogenous nature of TBI and variable pre brain injury patient factors and post brain injury course, this has proven to be a difficult task.

Large cohort studies have enabled improved accuracy in the prediction of 6 month mortality and unfavourable outcome.

Furthermore, many of the factors that contribute to long-term outcome have also emerged. However, it is not yet possible to use them in prediction algorithms or mathematical models.

There is emerging evidence that pre injury psychosocial and demographic factors may be of more relevance than injury severity. Moreover, that ‘outcome’ becomes increasingly subjective and complex as the post injury duration increases.

We end with three brief vignettes which highlight the fraught nature of long term outcome prediction.

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Kiran Lele

Kiran completed a fellowship year in TBI Psychiatry at Westmead Hospital last year. Kiran is also interested in the role of psychotherapy in the treatment of organic brain disorders such as TBI.