Traumatic brain injury (TBI) is considered a relevant worldwide cause of mortality and morbidity. Objective: To evaluate independent factors at hospital admission and during hospitalization that predicts in-hospital mortality in patients with TBI submitted to neurosurgery. Methods: Retrospective cohort analyzed data of patients that underwent neurosurgery due to the TBI. Evaluated predictor factors were age, gender, Glasgow Coma Scale (GCS) at admission, sequels before and after neurosurgery,

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... auma mechanism, and neurosurgical procedure. The survival analyses were verified. Positive and negative predictive values were calculated. Results: A total of 312 patients were analyzed, majority male (81.4%) with mild TBI (55.8%), and mean age of 49.6 ± 23.5 years. GCS at admission was an independent predictor of mortality (HR = 0.87; 95% CI: 0.81 to 0.93; p < 0.001). The GCS ≤ 13 was the optimal cut-off value to predict survival with a significant difference between GCS groups (≤13 or >13; p<0.001). Patients with GCS ≤ 13 had a six times greater risk of mortality (HR 6.04; 95 CI 2.39 to 15.3; p<0.001). The positive and negative predictive values were 35.8% and 97%, respectively. Conclusions: The GCS in admission is an important predictor of in-hospital mortality in TBI patients that need a neurosurgical procedure.