From the Guidelines
Mortality in patients with mild Traumatic Brain Injury (TBI) is less than 1%, with approximately 0.1% of patients requiring surgical intervention and dying. This is based on the most recent evidence from the Annals of Emergency Medicine, which reports that roughly 1% of patients with mild TBI will have intracranial injuries on imaging and be classified as having moderate or severe TBI, with fewer than 0.1% dying 1. The primary causes of death in mild TBI cases are typically intracranial hemorrhage that was initially undetected or developed after the initial assessment, particularly subdural or epidural hematomas.
Key Points to Consider
- Most patients with mild TBI recover completely without long-term consequences
- Certain risk factors can increase mortality risk, including older age, pre-existing medical conditions, and delayed medical attention after injury
- Prompt evaluation and monitoring, especially for high-risk patients, are crucial to minimize mortality risk
- Medical professionals typically follow protocols that may include neurological examinations, CT scans, and observation periods
Reducing Mortality Risk
To minimize mortality risk, patients with mild TBI should be evaluated promptly after injury, especially those with risk factors. The use of protocols such as neurological examinations, CT scans for high-risk patients, and observation periods can help identify potential complications early on. Most deaths from mild TBI occur within the first 48 hours, making this period critical for monitoring 1.
Morbidity and Quality of Life
While mortality is rare in mild TBI, the condition can still lead to significant morbidity, including post-concussion syndrome, cognitive impairments, and psychological effects that may persist for weeks to months after injury. The economic and societal burden of mild TBI is substantial, with estimated lifetime costs of $76.5 billion in the United States in 2010 1. Therefore, prevention and appropriate management of mild TBI are critical to reducing the economic and societal burden on the lives of Americans.
From the Research
Mortality Rate in Mild Traumatic Brain Injury (TBI)
- The mortality rate for patients with mild Traumatic Brain Injury (TBI) is relatively low, with a case fatality rate of 0.1% 2.
- Intracranial complications of Mild Traumatic Brain Injury (MTBI) are infrequent, occurring in approximately 10% of cases, and requiring neurosurgical intervention in a minority of cases (1%) 2.
- The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: an early phase post-traumatic disorder and a later phase post-traumatic disorder, with the later phase being highly influenced by psychosocial factors 3.
- Effective early phase management may prevent or limit the later phase disorder, and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications 3.
- The management of mild TBI requires a tailored approach, taking into account the severity of the injury and the individual symptom syndromes, and may involve neuroimaging, hospital admission, and follow-up care 4, 2, 5.
Factors Influencing Mortality Rate
- Age, loss of consciousness, persistent anterograde amnesia, focal deficit, skull contusion, and deterioration on the Glasgow Coma Scale (GCS) are risk factors that may increase the likelihood of intracranial complications and mortality in patients with mild TBI 2.
- The presence of bleeding disorders or the use of anticoagulants or antiplatelet agents may also increase the risk of intracranial injury and mortality in patients with mild TBI 5.
- Early and appropriate triage, as well as a systematic approach to management, can help reduce morbidity and mortality in patients with traumatic brain injuries 6.