"Talk and die" syndrome, a tragedy in traumatic brain injury: a cohort study.

BACKGROUND: Traumatic brain injury is one of the leading causes of mortality worldwide. Some patients with traumatic brain injury die in the field shortly after gaining semi-consciousness. However, few reports have discussed the "talk and die" phenomenon and its underlying causes and risk factors. METHODS: We conducted a prospective study of 353 patients with head injury with a Glasgow Coma Scale score 9-14 who were admitted to the neurotrauma unit of a tertiary university hospital from January 2019 to June 2020 to investigate "talk and die" syndrome and its associated risk factors. RESULTS: Most study patients were male (66.3%). The major type of trauma was road traffic accident. Among the eight patients who experienced the "talk and die" phenomenon, five were male, while three were female; the age range was 16-71 years, and time to deterioration ranged from 4.5 to 30 hours. CONCLUSION: The "talk and die" phenomenon can possibly be prevented. Although its prevalence is quite low, it is more likely to occur in older male patients with mild to moderate head injury. All patients with head injury should be well observed for not less than 30 hours; those with risk factors should be observed longer. Trial registration Retrospective study protocol was approved by the institutional review board committee of Faculty of Medicine, Zagazig University, Egypt (#IRB10232).