Objective: Establishing a reliable prognosis after surgery for traumatic brain injury(TBI) is difficult. Majority of the prognostic models help in morbidity and mortality assessment. In a developing country, unexpected prolonged hospital stay can have a cumulative effect on limited hospital resources and lessen the caretaker’s compliance. Patients &Methods: Records of 256 patients who had hospital stay for more than 15 days during a period of 3 years were obtained and grouped into 15-30 days (Group 1) and > 30 days (Group 2) of hospital stay groups. Demographic data, comorbid factors, mode of injury, Glasgow coma scale (GCS), pupil status, Computed tomography (CT) features, tracheostomy, associated significant injuries, septic foci with cultures and second-surgeries were compared and analyzed.Results: In Group 1, age<50 years, GCS:3-5 at presentation, bilateral fixed but normal sized pupils, bilateral fixed and dilated pupils, CT features of Extradural hematoma (EDH), subdural hematoma (SAH), cerebral edema & Midline Shift (MLS) of >6mm were found to be significantly associated with prolonged stay (p<0.001). In Group 2, GCS 6-8, unilateral fixed and dilated pupils, CT features of SDH & ischemia and infarcts, associated orthopedic injuries, abdominal injuries and soft tissue loss, comorbidities, pneumonia, tracheostomy, wound infection, meningitis, and second surgery, were found to have significant association ( p<0.001). No association was found with the mode of injury, GCS>9, contusions/IVH/ depressed fracture, chest injuries, chronic kidney disease, deranged coagulation, an appearance of seizures and microbial flora. Conclusion: Age, GCS at presentation, pupil size and reaction, CT features, second surgery, comorbid conditions and presence of tracheostomy with recurrent lower respiratory tract infection (LRTI)/ upper respiratory tract infection (URTI) were significant predictors of prolonged hospital stay. As majority of these can be assessed at the time of admission and happens in the due course, a fairly reliable prediction regarding duration of hospital stay can be can be established.

Keywords: Traumatic Brain Injury; GCS; Hospital Stay; Prognostic Factor.