{
  "abstract": "Background Recovery following traumatic brain injury (TBI) is highly heterogeneous. Characterising longitudinal functional trajectories may enable more individualised care and inform the trial design. This study aimed to identify distinct patterns of functional recovery in the first 12 months post-injury using the Glasgow Outcome Scale – Extended (GOSE).Methods Patients with available GOSE data from Transforming Research and Clinical Knowledge in Traumatic Brain Injury, a prospective, multicentre study, were included. A two-stage multiple imputation procedure addressed missingness, and trajectories were modelled using polytomous variable latent class analysis (poLCA) in both complete-case and imputed datasets.Results Among the 2,100 participants with TBI, poLCA identified seven distinct recovery trajectories based on GOSE scores. These included (1) death (6.2%), (2) persistent GOSE 2–5 (5.7%), (3) improvement from GOSE 3–5 to GOSE 5 by 3 months with no further gains (9.0%), (4) rapid improvement from GOSE 3–5 to GOSE 7–8 sustained through follow-up (7.0%), (5) gradual improvement from GOSE 3–6 to GOSE 5–7 over 6 months (15.3%), (6) rapid early improvement from GOSE 4–7 to GOSE 6–8 by 3 months and then plateauing (21.8%) and (7) progression from GOSE 5–8 to GOSE 7–8 within 3 months, with stable outcomes thereafter (25.1%). Recovery class membership was significantly associated with the initial Glasgow Coma Scale scores, CT severity (Marshall and Rotterdam scores) and presence of psychiatric comorbidities.Conclusions Our findings support a shift towards trajectory-based stratification in clinical care and research. Incorporating these patterns into prognostic modelling may improve outcome prediction, personalise rehabilitation and refine eligibility criteria for interventional trials.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, Health Service, Brisbane, Queensland, Australia",
        "The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Peter Paramaseeven Curpen"
    },
    {
      "affiliations": [
        "The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Xuan Vinh To"
    },
    {
      "affiliations": [
        "Griffith University, Brisbane, Queensland, Australia"
      ],
      "name": "Ming Lu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia"
      ],
      "name": "Craig Winter"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia"
      ],
      "name": "Judith Bellapart"
    },
    {
      "affiliations": [
        "Division of Anaesthesia, Cambridge University, Cambridge, UK",
        "Wolfson Brain Imaging Centre, Cambridge University, Cambridge, UK"
      ],
      "name": "Virginia FJ Newcombe"
    },
    {
      "affiliations": [
        "The University of Queensland Queensland Brain Institute, Brisbane, Queensland, Australia"
      ],
      "name": "Fatima Nasrallah"
    }
  ],
  "title": "Trajectories of Glasgow Outcome Scale-Extended after traumatic brain injury: an analysis of the TRACK-TBI cohort",
  "uid": "3c4bc48e-b02e-5a92-b573-80c734a414a8"
}