Subdural hematoma. Blood collects between the skull and the surface of the brain, which can occur after a head injury.
Scott Kamazin/Alamy
A significant proportion of people with traumatic brain injuries who are taken off life support may survive and at least partially recover, research suggests.
Traumatic brain injuries can be caused by a hard blow, a blow to the head, or an object that enters the brain, such as a bullet. Although it can be difficult to predict an individual's outcome, some people recover and are at least partially independent after a few months. Still, families are often asked to decide whether to discontinue life-sustaining treatment within days of a serious injury.
If you would like to learn more about the potential consequences of such an event, Elena Bodien Researchers at Massachusetts General Hospital collected data over seven and a half years on people who had sustained traumatic brain injuries and were on life support in intensive care units in the United States.
Of these people, 80 were taken off life support and their outcomes were compared with those who continued treatment, some of whom regained some independence.
Researchers identified factors associated with removing life support, including a person's age and gender. From this, they used an algorithm to calculate the likelihood that these people would recover if treatment was maintained.
These results suggest that 42% of people taken off life support may have survived and been at least partially independent 6 to 12 months after injury.
“Prognosis after traumatic brain injury” [traumatic brain injury] is very uncertain, and communicating this uncertainty to families is very important,” says Bodien. “Our results suggest that a more cautious approach is needed when establishing prognosis.” [and that] Careful consideration is required when making irreversible decisions, such as discontinuing life-sustaining treatment. ”
The lack of information about the long-term outcomes of TBI is one reason why prognosis is difficult to predict, leading clinicians to assume that a poor outcome is likely and She says they may recommend discontinuing the maintenance device.
damian cruise Researchers from the University of Birmingham in the UK say the results should be interpreted with some caution. “The decision to withdraw is multifaceted and does not necessarily depend on the dichotomy of 'vegetative state or not', but rather whether the level of recovery is satisfactory to the patient.” he says. he says.
“However, it is clear from this and other data that predictions of recovery from the early stages following an injury are not as accurate as one would hope, especially as these predictions influence difficult choices for families.”
In the future, researchers hope to compare recovery rates after severe traumatic brain injury among people in countries other than the United States, Bodien said.
“We are also conducting research to understand which statistical methods for estimating outcomes are most accurate, and estimating potential outcomes for patients who die after withdrawal of life support. It could be used in future research,” she says.
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Source: www.newscientist.com
