TY - JOUR
T1 - Predictors of Access to Rehabilitation in the Year Following Traumatic Brain Injury
T2 - A European Prospective and Multicenter Study
AU - CENTER-TBI Participants and Investigators
AU - Jacob, Louis
AU - Cogné, Mélanie
AU - Tenovuo, Olli
AU - Røe, Cecilie
AU - Andelic, Nada
AU - Majdan, Marek
AU - Ranta, Jukka
AU - Ylen, Peter
AU - Dawes, Helen
AU - Azouvi, Philippe
PY - 2020/9
Y1 - 2020/9
N2 - BACKGROUND: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care.OBJECTIVE: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI.METHODS: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge.RESULTS: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24).CONCLUSIONS: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.
AB - BACKGROUND: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care.OBJECTIVE: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI.METHODS: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge.RESULTS: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24).CONCLUSIONS: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.
KW - Europe
KW - international prospective study
KW - predictive factors
KW - rehabilitation
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85089102230&partnerID=8YFLogxK
U2 - 10.1177/1545968320946038
DO - 10.1177/1545968320946038
M3 - Article
C2 - 32762407
SN - 1545-9683
VL - 34
SP - 814
EP - 830
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 9
ER -