Reclassifying brain injury – what’s in a name?

Following a report undertaken by the National Academies of Sciences, Engineering and Medicine, the Brain Injury Association of America has recently advised that a reclassification system for TBIs is being considered.

The report, Traumatic Brain Injury: a Roadmap for Accelerating Progress, argued that the current TBI classification framework of mild, moderate or severe was "inaccurate, outdated and does not effectively serve patients, clinicians or payers".

It is felt that data accumulated over the last 10 years shows the existing terminology is too crude and is not indicative of a patient's recovery. There are cases where the TBI is ‘mild’ yet the patient has not returned to work within a year of the injury and, conversely, where the injury is ‘severe’ yet the recovery does not accord with the label of a severe TBI. Consequently the patients are not receiving the appropriate treatment they may require.

A TBI Classification Working Group has been set up, consisting of medical professionals and researchers specialising in brain injury. They will work together to come up  with a new reclassification system which will put greater emphasis on factors such as patient’s Glasgow Coma Scale score, imaging, blood-based biomarkers and pre-morbidity. The group will present their findings and recommendations at a US conference in January 2024.

Setting up a working group tasked with looking into the reclassification of TBIs is not a surprising development. The current classification system of mild, moderate and severe not being aligned to the outcomes is something that our experts have identified for some time. Whether any changes are made and how long they take, remains to be seen. However, if changes are made in the US, this may well prompt alterations to the UK classification system. Watch this space.

Alexandra Puddy - Brain Injury SIG member