Long-term outcomes of moderate to severe diffuse axonal traumatic brain injury: a prospective study

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Introduction: Traumatic brain injury (TBI) with diffuse axonal injury (DAI) necessitates significant medical and rehabilitation interventions. The late long-term outcome is variable with potential for neurodegenerative development and deterioration. This study evaluates the late long-term outcomes of moderate to severe TBI with DAI. Methods: Patients aged 16–65 with moderate to severe TBI and DAI were included. From 2006 to 2018, 30 patients (mean age 34; 21 males, 9 females) were enrolled. Outcomes were assessed using the Glasgow Outcome Scale Extended (GOSE) at 6 months and ≥ 1-year post-injury. Results: At 6 months, 10 patients had a favourable outcome (GOSE 6–8), increasing to 12 at ≥ 1-year post-injury. Patients with unfavourable outcomes were older (mean 40) than those with favourable outcomes (mean 24, p < 0.001). DAI stage correlated with outcomes (p = 0.003). GOSE remain-ed unchanged in 15 patients, improved in 9 and deteriorated in 6 between the 6 months and the ≥ 1-year follow-up. Discussion: Approximately one-third of TBI patients with DAI achieved favourable long-term outcomes, and the outcome changed in half of the patients between 6 months and ≥ 1 year follow-up. Age and DAI stage were significant predictors of outcome. Further studies are required to enhance prognostic accuracy and explore rehabilitation’s impact.