Traumatic brain injury in Pakistan linked to poor long-term survival
Traumatic brain injury (TBI) in Pakistan is associated with a high risk of death and disability long after the initial injury, even in mild to moderate cases, according to two new studies in JAMA Network Open led by Weill Cornell Medicine researchers. While most TBIs occur in low- and middle-income countries because of road traffic accidents, long-term patient outcomes remain poorly understood.
Two studies from Weill Cornell Medicine researchers reveal that traumatic brain injuries (TBIs) in Pakistan lead to high long-term mortality and disability, even in mild to moderate cases. While most TBIs occur in low- and middle-income countries due to road traffic accidents, understanding long-term patient outcomes remains limited.
Researchers analyzed data from two trauma centers in Karachi, Pakistan, over a year after injury. The first study examined 819 patients with moderate to severe TBI, finding that 60% of deaths occurred within the first month after discharge, suggesting vulnerability during the transition from hospital care to life at home. Twelve months post-injury, mortality reached nearly 60% for moderate TBI patients and 88% for severe cases, compared to 9% and 30% in high-income countries.
The second study assessed 602 patients with mild TBI, defining GCS scores of 13 to 15. While mild TBI patients typically have better outcomes, researchers found that lower GCS scores predicted worse prognosis, including higher mortality and poorer quality of life. These findings highlight the need for stronger trauma systems, including faster access to appropriate care, post-discharge monitoring, and expanded rehabilitation services, to prevent many deaths and disabilities in Pakistan and similar low-resource settings.
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