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Study finds that more than 40% of patient with traumatic brain injuries who died after life support withdrawn may have recovered

by | May 23, 2024

By Dave Andrusko

A fascinating and troubling study that appears in the current issue of the Journal of Neurotrauma suggest a substantial proportion of patients with traumatic brain injury may have survived “and achieved at least partial independence” had not life-sustaining treatment been withdrawn.

The nine authors, led by corresponding author Dr. Yelena Bodien, of Massachusetts General Research Institute, don’t quite put it that bluntly. However, a press release from Mass General Brigham does:

Study Reveals Patients with Brain Injuries Who Died After Withdrawal of Life Support May Have Recovered

“Our findings support a more cautious approach to making early decisions on withdrawal of life support” Dr. Bodien said. “Traumatic brain injury is a chronic condition that requires long-term follow-ups to understand patient outcomes. Delaying decisions regarding life support may be warranted to better identify patients whose condition may improve.”

The abstract for the article—titled “Recovery Potential in Patients Who Died After Withdrawal of Life-Sustaining Treatment: A TRACK-TBI Propensity Score Analysis”—begins

Among patients with severe traumatic brain injury (TBI), there is high prognostic uncertainty but growing evidence that recovery of independence is possible. Nevertheless, families are often asked to make decisions about withdrawal of life-sustaining treatment (WLST) within days of injury. 

Researchers from Massachusetts General Hospital, Harvard Medical School, and other universities studied 1,392 patients who were treated in 18 trauma centers across the U.S. over a 7½-year period. They “analyzed ‘potential clinical outcomes’ for patients with traumatic brain injury (TBI) who were removed from life support,” according to Fox News’s Melissa RudyShe interviewed Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the research, who called it a “very important” study.

“Previous research shows a high-level recovery from mild TBI and a significant recovery percentage even with moderate to severe injury,” Siegel told Fox News Digital.

“After head trauma, the brain may swell, and the use of mannitol and steroids and even sometimes surgery — where the top of the skull is removed — can be used to decrease pressure on the brain and increase chance of a full recovery,” he continued. 

Rehabilitation is also crucial, Siegel added.

“All of these tools should be given a chance to work in most cases.”

Stephen Beech writes that using the data collected, “the researchers created a mathematical model to calculate the likelihood of withdrawal from life-sustaining treatment.”

Needless to say, everyone who had “life-sustaining treatment” withdrawn died. But “among the group for whom life support was not withdrawn, more than 40% recovered at least some independence, according to a press release,” Rudy wrote.

She added

Based on the study findings, Bodien recommended that clinicians should be “very cautious” with “irreversible decisions” like withdrawing life support in the days following traumatic brain injury

“Families should also be aware of our results so that they can advocate for delaying a decision to discontinue life support if this is aligned with what they believe their loved one would want,” she added. 

Categories: Brain Injury