• Sina Zoghi, Ali Ansari, Amin Niakan, Reza Taheri, and Hosseinali Khalili.
• Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
• World Neurosurg. 2024 Sep 1; 189: e580e590e580-e590.

BackgroundTraumatic brain injury (TBI) is a major cause of physical disabilities worldwide. Herein, we aimed to investigate the factors contributing to post-discharge recovery in patients who were discharged with an unfavorable outcome.MethodsWe collected data on the characteristics of patients, with a focus on those who survived TBI but had an unfavorable outcome at discharge as measured by Glasgow Outcome Scale Extended (GOSE) categories 2, 3, and 4. Post-discharge recovery was defined as achieving a favorable functional status at 6 months (GOSE of 5 or more) with a minimum 2-point increase in GOSE.ResultsOf 4011 TBI patients in our registry, 797 had an unfavorable discharge functional status. In severe TBI, 51% achieved recovery, while in mild to moderate TBI, 57% achieved recovery after 6 months. Older patients and those with shorter intensive care unit length of stay were more likely to experience post-discharge recovery in both mild to moderate and severe TBI groups. The presence of skull base fracture was also associated with post-discharge recovery in severe TBI patients. Lastly, we show that, after adjustment for potential confounders, GOSE at discharge is associated with post-discharge recovery in both mild to moderate and severe TBI patients.ConclusionsThis study found that the majority of patients discharged with an unfavorable functional status were able to achieve a favorable outcome within 6 months. The novel post-discharge recovery in TBI patients might be a useful tool for illuminating the factors associated with a significant improvement after discharge.Copyright © 2024. Published by Elsevier Inc.

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