Acute Neuroimaging Findings Are Associated with Poor Outcome after Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis.
Breanna K Nelson, Sidney A Saint, Lea N Farah et al.
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In 30 seconds
This systematic review and meta-analysis examined whether acute neuroimaging findings after mild traumatic brain injury (mTBI) are associated with outcomes. It included 64 studies in the review and 25 in meta-analyses, drawing on prospective studies or retrospective analyses of prospective data. Compared with patients without acute imaging findings, those with findings had higher odds of poor outcome (OR = 2.04 [1.29-3.24], p = 0.0024, k = 7, n = 2,947). Imaging findings were also associated with loss of consciousness, but not with post-traumatic amnesia or post-concussion symptoms.
Key findings
- Acute imaging findings were associated with higher odds of poor outcome: OR = 2.04 [1.29-3.24], p = 0.0024, k = 7, n = 2,947.
- Imaging findings were associated with loss of consciousness: OR = 1.42 [1.02-1.97], p = 0.039, k = 15, n = 3,912.
- No association was found with post-traumatic amnesia (OR = 1.27 [0.65-2.49], p = 0.49) or post-concussion symptoms (Hedge's g = 0.00 [-0.17-0.17], p = 0.97).
Why it matters
The findings suggest that acute neuroimaging abnormalities after mTBI may help identify patients at greater risk of poor functional outcomes. The lack of association with post-traumatic amnesia and post-concussion symptoms also indicates that imaging findings do not correspond uniformly to all measures of injury severity or recovery.
What to keep in mind
Only 25 of the 64 included studies contributed to meta-analyses; the poor-outcome estimate was based on seven studies.