A 12-month follow-up of long-term functional and clinical outcomes among adults with traumatic brain injury in Indonesia

Abstract

Traumatic brain injury (TBI) remains a significant global and national health issues that leading to high rates of disability and mortality. Understanding long-term outcomes is pivotal for rehabilitation strategies and clinical management. In the context of nursing care, ongoing follow-up and assessment contribute in optimizing recovery. However, study focusing this clinical issue is limited particularly in Indonesia. Therefore, the study aims to evaluate the 12-month functional outcomes of patients with moderate and severe TBI using the Glasgow Outcome Scale Extended (GOSE), identify predictors of recovery and mortality, and draw attention to the nurse’s role in the care continuum. In this study, a prospective cohort design was used to meet its objectives. The study initially enrolled 64 patients with moderate to severe TBI. Out of these, 46 patients were successfully contacted and participated. Data was collected on demographic characteristics, Glasgow Coma Scale (GCS) scores at admission, and GOSE scores at 12 months. Descriptive statistics and bivariate test were used for data analysis. The significance level was considered at 0.05 for hypothesis testing. The study documented that among the 46 patients, 18% died, while the others experienced varying levels of disability and recovery. Younger age and higher GCS scores at admission were significantly associated with better outcomes (p < 0.05), whereas sex was not (p > 0.05). Low initial GCS scores, older age, and delayed referrals were major factors contributing to mortality. Nurses were crucial in early clinical stabilization, educating patients and their families, and providing long-term follow-up care. Younger patients and those with higher GCS scores upon admission generally experienced better long-term functional outcomes. Nursing roles are vital in supporting recovery through acute management, rehabilitation coordination, and psychosocial support. This study underscores the necessity of nurse-led interventions to improve outcomes in TBI care.

Keywords: Glasgow Coma Scale, Glasgow Outcome Scale Extended, long-term outcomes, rehabilitation, traumatic brain injury