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Background: Traumatic brain injury (TBI) is a major public health problem with high mortality and disability. Vitamin E, one of the antioxidants for the treatment of TBI, has not been sufficiently evaluated for predicting the long-term prognosis after TBI. This study aimed to evaluate the prognostic value of vitamin E on clinical outcomes of TBI patients. Methods: A multi-center prospective cohort study was conducted in 5 university hospitals between 2018 and 2020 in Korea. All adult patients who were under 65 years of age and who visited the ED using an ambulance for head trauma were eligible. Primary and secondary outcomes were poor neurological outcome (Glasgow outcome scale (GOS) 1-4) and 1-month mortality after hospital discharge. We calculated the adjusted odds ratios (AORs) of the vitamin E for related outcomes adjusting for potential confounders. Results: Among 237 eligible TBI patients, 75 (31.6%) were classified into the poor neurological outcome group. Vitamin E level below the reference range was more observed in the poor neurological outcome group (p-value 0.04). In a univariate analysis, vitamin E depletion group showed significant higher 1-month mortality (ORs (95% CI): 5.52 (1.09-27.93)). However, there was no benefit in 1-month mortality after adjusting for confounders (adjusted ORs (95% CI): 1.57 (0.20-12.27)). And there was no significant difference in 1-month GOS between the two groups (ORs (95% CI): 2.75 (0.79-9.52)). Conclusion: Low level of serum vitamin E at ED arrival was associated with poor neurological outcome following TBI. There was only a benefit in 1-month mortality in a univariate analysis and no significant difference in 1-month mortality and 1-month GOS after adjusting for confounders.

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