Predictors of Access to Rehabilitation in the Year Following Traumatic Brain Injury: A European Prospective and Multicenter Study

CTR-TBI Participants Investigators, Louis Jacob*, Melanie Cogne, Olli Tenovuo, Cecilie Roe, Nada Andelic, Marek Majdan, Jukka Ranta, Peter Ylen, Helen Dawes, Philippe Azouvi

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Article number1545968320946038
Pages (from-to)814-830
Number of pages17
JournalNeurorehabilitation and neural repair
Volume34
Issue number9
DOIs
Publication statusPublished - Sep-2020

Keywords

  • traumatic brain injury
  • rehabilitation
  • predictive factors
  • international prospective study
  • Europe
  • CENTER-TBI
  • CARE
  • EPIDEMIOLOGY
  • MODERATE
  • HEALTH
  • MORTALITY
  • PATHWAYS
  • RECOVERY
  • OUTCOMES
  • IMPACT

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