Does Diffuse Axonal Injury MRI grade really correlate with functional outcome

Abstract Background Diffuse axonal injury (DAI) is a common form of primary head injury. This study was done to see the association of DAI grades with extended glasgow outcome scale (GOSE) Methods We retrospectively reviewed the charts and radiology reports of a cohort of patients discharged with the diagnosis of diffuse axonal injury. We collected data on variables like age, sex, GCS at admission, grade of DAI, length of hospital stay, and occurrence of post-traumatic seizures. We called up the patient after six months to assess their GOSE. Outcome analysis was done with SPSS v 23. Results Fourty patients DAI and six months GOSE were available for analysis. Mean age was 27.8 years with male to female ratio of 12:1. There were eight patients with DAI grade I (20.5%), 13 patients with DAI grade II (33.3%) and 18 patients with DAI grade III (46.2%). Nine of 39 patients (23.07%) had post-traumatic seizures. Mean GCS at admission was 9.67. Mean length of hospital stay was 24.12 days. Mean GOSE after six months was 6.10. There were five mortalities. Patients with low mean GCS portended significant unfavorable outcome. Higher DAI grades were not associated with unfavorable outcome. Conclusion Mean GCS at presentation is a better predictor of outcome after DAI rather than its grade.