Decisions involving when to withdraw life-sustaining measures for those with moderate to severe traumatic brain injury should not be made in the early days following injury according to researchers at UC San Francisco. That’s because they have uncovered data that is encouraging for these types of patients.
In a July 6, 2021, study published in JAMA Neurology, researchers led by UC San Francisco, Medical College of Wisconsin and Spaulding Rehabilitation Hospital followed 484 patients with moderate-to-severe TBI (traumatic brain injury). They found that among the patients in a vegetative state, 1 in 4 “regained orientation” — meaning they knew who they were, their location and the date — within 12 months of their injury.
“Withdrawal of life-sustaining treatment based on early prediction of poor outcome accounts for most deaths in patients hospitalized with severe TBI,” said senior author Geoffrey Manley, MD, PhD, professor and vice chair of neurological surgery at UCSF and chief of neurosurgery at San Francisco General Hospital, noting that 64 of the 92 fatalities in the study occurred within two weeks of injury.
“TBI is a life-changing event that can produce significant, lasting disability, and there are cases when it is very clear early on that a patient will not recover,” he said. “But results from this study show a significant proportion of our participants experienced major improvements in life functioning, with many regaining independence between two weeks and 12 months after injury.”