Virginia Via Research Day Book 2026

Medical Student Research Clinical

01 EXPLORING THE RELATIONSHIP BETWEEN QUALITY OF LIFE AND GLASGOW OUTCOME SCALE-EXTENDED SCORES IN MODERATE-TO-SEVERE TRAUMATIC BRAIN INJURY: A MULTI-DOMAIN REGRESSION

Brooke Scardina, OMS-III; Mason Nelson, OMS-III; Ramzi Badra, OMS-III; Varun Mishra, MS-IV; Taylor P. van Doren, PhD; Melissa Martinez, NP-C; Justin L. Weppner, DO Corresponding author: jlweppner@carilionclinic.org

VCOM-Virginia, Blacksburg, Virginia Virginia Tech-Carilion School of Medicine, Roanoke, Virginia High Point University, High Point, North Carolina Carilion Clinic Brain Injury Center, Roanoke, Virginia Context: Traumatic brain injury (TBI) is a leading cause of long-term disability. While the Glasgow Outcome Scale-Extended (GOSE) assesses functional recovery, it does not capture patient-reported quality of life, which the Quality of Life after Brain Injury (QOLIBRI) questionnaire measures. This study examines whether GOSE scores predict QOLIBRI domain scores in adults with moderate-to-severe TBI (msTBI). Objective: To determine whether GOSE scores are predictive of quality of life (QOL) in msTBI patients across six domains of the QOLIBRI and to assess how demographic and injury-related factors influence this relationship. We hypothesize that GOSE score is positively associated with QOLIBRI scores, and that domain-specific variation in strength of association will exist. Methods: We prospectively enrolled 138 adults aged 18-65 with msTBI (Glasgow Coma Scale 3-12, loss of consciousness >30 min, or post-traumatic amnesia >24hrs) one-year post-injury. GOSE scores ranged from 3 to 8. Two ordinary least squares (OLS) regression models were developed: Model 1 included

GOSE alone; Model 2 adjusted for age, sex, injury severity, QOLIBRI domain, and GOSE-by-domain interactions. Results: The cohort (mean age 35 +/-14.04 years) included 110 males and 112 severe cases; most common injury mechanisms were motor vehicle collisions (n=72), falls (n=26), and blunt trauma (n=26). Mean GOSE was 6.32 +/- 1.56 (median 7, range 3-8). Model 1 found GOSE to be a significant but weak predictor of QOL (B = 0.81, p < 0.001; adj-R^2 = 0.019). Model 2 showed substantially improved fit (adj-R^2 = 0.67). Age (B = 0.062, p < 0.001) and male sex (B=1.01, p = 0.023) predicted higher QOL; injury severity was not significant. GOSE interacted significantly with the Independence (B= 2.8, p < 0.001) and Thinking (B = 1.5, p < 0.001) domains, suggesting that functional recovery most strong influences autonomy and cognition. A negative trend for GOSE*Physical (B = -0.74, p = 0.065) was observed, aligning with reduced symptoms burden but did not reach significance. Conclusion: GOSE scores are associated with QOL, but this relationship is highly domain-dependent.

Functional recovery has the greatest impact on independence and cognitive function. Incorporating QOLIBRI into TBI care may improve the precision of outcome tracking and rehabilitation strategies. IRB Statement: This study was approved by the Carilion Clinic IRB, protocol number 24-1932.

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172 Edward Via College of Osteopathic Medicine (VCOM)