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The Relationship Between Injury Characteristics and Post-Traumatic Recovery After Diffuse Axonal Injury

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Journal Biomedicines
Date 2024 Feb 24
PMID 38397913
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Abstract

Background: The diagnosis and prognosis of diffuse axonal injury (DAI) remain challenging. This research aimed to analyze the impact on activities of daily living (ADL), functional outcomes, quality of life (QoL), and the association between lesion severity and DAI location identified through imaging exams.

Methods: This prospective cohort study included 95 patients diagnosed with DAI. Data were collected at admission, three, six, and twelve months post-injury. The associations between variables were evaluated using a mixed-effects model.

Results: Functional recovery and QoL improved between three and twelve months after DAI. An interaction was observed between independence in performing ADL and subarachnoid hemorrhage ( = 0.043) and intraventricular hemorrhage ( = 0.012). Additionally, an interaction over time was observed between the Glasgow Outcome Scale (GOS) and DAI severity ( < 0.001), brain lesions ( = 0.014), and the Disability Rating Scale (DRS) with injury in brain hemispheres ( = 0.026) and Adams classification ( = 0.013). Interaction effects over time were observed with the general health perceptions and energy/vitality domains with intraventricular hemorrhage, and the social functioning domain with the obliteration of basal cisterns and Gentry's classification.

Conclusion: The use of CT in the acute phase of DAI is important for predicting outcomes. The severity and location of DAI are associated with functional outcomes, ADL, and QoL.

References
1.
Yanagawa Y, Sakamoto T, Takasu A, Okada Y . Relationship between maximum intracranial pressure and traumatic lesions detected by T2*-weighted imaging in diffuse axonal injury. J Trauma. 2009; 66(1):162-5. DOI: 10.1097/TA.0b013e3181469857. View

2.
Figueira Rodrigues Vieira G, Guedes Correa J . Early computed tomography for acute post-traumatic diffuse axonal injury: a systematic review. Neuroradiology. 2020; 62(6):653-660. PMC: 7222974. DOI: 10.1007/s00234-020-02383-2. View

3.
Henninger N, Compton R, Khan M, Carandang R, Hall W, Muehlschlegel S . "Don't lose hope early": Hemorrhagic diffuse axonal injury on head computed tomography is not associated with poor outcome in moderate to severe traumatic brain injury patients. J Trauma Acute Care Surg. 2017; 84(3):473-482. PMC: 5820140. DOI: 10.1097/TA.0000000000001733. View

4.
Katz S, Ford A, Moskowitz R, Jackson B, JAFFE M . STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963; 185:914-9. DOI: 10.1001/jama.1963.03060120024016. View

5.
Oliveira D, Vieira R, Pipek L, de Sousa R, De Souza C, Santana-Santos E . Long-Term Outcomes in Severe Traumatic Brain Injury and Associated Factors: A Prospective Cohort Study. J Clin Med. 2022; 11(21). PMC: 9655294. DOI: 10.3390/jcm11216466. View