Statement of Purpose Traumatic brain injuries (TBI) are associated with long-term disabilities. Because little is known on the burden of TBI associated disability in Saudi Arabia, this study aims to examine health outcomes of TBI survivors and whether receiving rehabilitation services is associated with improved outcomes in a level-I trauma centre.

Methods In this study, 760 patients (age 16–60) met the inclusion criteria: hospitalised due to a TBI between years 2005–2014. Patients were contacted via the phone and Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) surveys were administered. In addition to univariate analyses, multiple logistic regression models were constructed to estimate the association between rehabilitation services and the presence of long-term disabilities.

Results Over 90% of the patients sustained TBIs following a traffic crash. Of the 260 patients who responded, 32.7% reported at least some limitations in ADL or IADL. Half of patients received at least one session of rehabilitation services and patients receiving these services were more likely to be severely injured (Mean severity=17.3 vs. 12.2, p<0.01). Average time since injury was 6.8 years (range=3–12, SD=2.6). Regression findings suggested that those who received rehabilitation services were more than two times more likely to report at ADL disability (OR=2.3; P-value=0.01). However, no difference between the two groups was detected after incorporating propensity score matching.

Conclusions Prevention programs to reduce the burden of traffic crashes are desperately needed. Despite adjusting for confounders, we found no differences in health outcomes between the two groups. Because we had no information on the duration of rehabilitation programs, it is possible that patients did not complete the recommended rehabilitation course. Further studies are warranted to elucidate the reasons for these findings. Significance and

Contributions This study highlights the long-term burden of preventable injuries on population health of Saudi Arabia.