{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:28:40Z","timestamp":1786638520961,"version":"build-2736575974"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Mild traumatic brain injuries (mTBIs) are the most common form of TBI and are responsible for 1.37 million years lived with disability annually, disproportionately affecting low- and middle-income countries (LMICs), as 90% of TBIs occur in LMICs.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To measure the long-term mortality (12 months), quality of life (QoL), and functional status of patients with mTBI in Pakistan.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study was an analysis of prospectively collected data of patients with mTBI from a trauma registry of all injured patients from 2 tertiary care centers in Karachi, Pakistan, from December 2021 to May 2024, who were followed up for 12 months. Participants were adult patients (aged &amp;gt;18 years) admitted with mTBI and enrolled in the registry with recorded outcomes at 1, 3, 6, and 12 months.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Mild TBI (Glasgow Coma Scale [GCS] score of 13-15).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Long-term mortality (12-month cumulative and follow-up) was the primary outcome, and QoL was the secondary outcome.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 602 patients presented with mTBI. Most were aged 18 to 39 years (336 patients [55.8%]), were male (502 patients [83.4%]), and experienced mTBIs from road traffic collisions (427 patients [71.1%]), or falls (130 patients [21.6%]). Surgical interventions were performed in 176 cases (29.2%) and were associated with 51% lower odds of 1-month cumulative mortality (adjusted hazard ratio, 0.44; 95% CI, 0.21-0.87). The inpatient, cumulative 1-month, and 12-month mortality rates were 4.6%, 8.9%, and 13.6%, respectively. Patients with a GCS score of 13 (20.2%) and 14 (20.1%) had a higher 12-month mortality rate as compared with patients with a GCS score of 15 (8.3%). Of 345 patients with follow-up data at 1 year, 269 (78.0%) achieved complete independence by 1 year. The functional engagement domain showed the highest rate of recovery (318 patients [92.2%]), while the physical well-being and recovery domain had the lowest, with 286 (82.9%) experiencing disability, particularly those with a GCS score of 13 and 14; only 59 (17.1%) reported no physical disability at 12 months.<\/jats:p>\n <\/jats:sec>\n \n Conclusion and relevance<\/jats:title>\n In this cohort study of patients with mTBI in Pakistan, 12-month mortality was approximately 2-fold higher in patients with a GCS score of 13 to 14 (20.2% and 20.1%) compared with a GCS score of 15 (8.3%), alongside persistently poorer quality of life in lower-GCS score groups throughout the recovery period.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.29041","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:30:28Z","timestamp":1786635028000},"page":"e2629041","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Mortality and Quality of Life Among Adults With Mild Traumatic Brain Injury"],"prefix":"10.1001","volume":"9","author":[{"given":"Kantesh","family":"Kumar","sequence":"first","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal","family":"Abdul Rahim","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrose","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid","family":"Ali","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheza","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Weill Cornell Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanweer","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saima","family":"Mushtaq","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Jinnah Postgraduate Medical Centre, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Shahzad","family":"Shamim","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaheer","family":"Babar","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasir","family":"Shafiq","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huba","family":"Atiq","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Haider","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junaid","family":"Razzak","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Pakistan"},{"name":"Department of Emergency Medicine, Weill Cornell Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"issue":"4","key":"zoi260790r1","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","article-title":"Estimating the global incidence of traumatic brain injury.","volume":"130","author":"Dewan","year":"2018","journal-title":"J Neurosurg"},{"issue":"1","key":"zoi260790r2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/jsprm\/snab002","article-title":"Determining the global outcomes of traumatic brain injury in low-, middle- and high- income countries: a prospective, global neurosurgery, multicenter 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