Mortality after discharge from post acute rehabilitation following moderate to severe acquired brain injury - an overall prognosis study

TY - CONF

T1 - Mortality after discharge from post acute rehabilitation following moderate to severe acquired brain injury - an overall prognosis study

AU - Pommerich, Uwe M.

AU - Kjeldsen, Simon Svanborg

AU - Honoré, Helene

PY - 2023

Y1 - 2023

N2 - Background: Optimised acute care treatment has increased survival rates for patients with acquired brain injury. Severely affected patients are typically referred to comprehensive neurological inpatient rehabilitation. Rehabilitation is a process aimed at a) recovering maximum potential functioning and b) assistance in achieving a meaningful life post-injury. Hereto, rehabilitation is effective for most patients. Yet, increased mortality post-rehabilitation discharge is suspected, but lacks a systematic investigation. Such an investigation will provide mortality rates in the context of the current care and referral system and may provide valuable information for clinical decision-making and healthcare policies. Hence, the objective of the present study is to describe the overall prognosis for the all-cause mortality in people with acquired brain injury after discharge from inpatient rehabilitation. Of particular interest in the present study are the 3-month and 1-year periods post-discharge. Methods: A retrospective cohort of patients admitted to Hammel Neurorehabilitation Centre between March 2011 and February 2022 was investigated. Routinely collected personal health-data were extracted from the electronic healthcare records. Data from the electronic healthcare records was deterministically linked on an individual level. Crude and adjusted mortality rates were estimated for the first 3 months, first year and the entire follow-up period post-discharge.Results: A total of 6,182 patients were included. Patients were mostly male (62%), older than 41 years (83%), and suffered a stroke (61%). Five percent of patients (n=337) died during the 1-year follow-up period; Hereof 150 patients (2%) died within three months' post-discharge. Mortality rates were considerably higher in the first 3-months compared to the first year post-discharge. This pattern was consistent across age groups and ABI subtypes. Reduced levels of functioning at discharge contributed considerably to increased mortality rates after adjustment for age and level of functioning at admission.Conclusion: In the present cohort of patients, a considerable mortality was observed post-discharge from comprehensive rehabilitation. Mortality rates dropped markedly after three months. This observation should be considered and investigated further

AB - Background: Optimised acute care treatment has increased survival rates for patients with acquired brain injury. Severely affected patients are typically referred to comprehensive neurological inpatient rehabilitation. Rehabilitation is a process aimed at a) recovering maximum potential functioning and b) assistance in achieving a meaningful life post-injury. Hereto, rehabilitation is effective for most patients. Yet, increased mortality post-rehabilitation discharge is suspected, but lacks a systematic investigation. Such an investigation will provide mortality rates in the context of the current care and referral system and may provide valuable information for clinical decision-making and healthcare policies. Hence, the objective of the present study is to describe the overall prognosis for the all-cause mortality in people with acquired brain injury after discharge from inpatient rehabilitation. Of particular interest in the present study are the 3-month and 1-year periods post-discharge. Methods: A retrospective cohort of patients admitted to Hammel Neurorehabilitation Centre between March 2011 and February 2022 was investigated. Routinely collected personal health-data were extracted from the electronic healthcare records. Data from the electronic healthcare records was deterministically linked on an individual level. Crude and adjusted mortality rates were estimated for the first 3 months, first year and the entire follow-up period post-discharge.Results: A total of 6,182 patients were included. Patients were mostly male (62%), older than 41 years (83%), and suffered a stroke (61%). Five percent of patients (n=337) died during the 1-year follow-up period; Hereof 150 patients (2%) died within three months' post-discharge. Mortality rates were considerably higher in the first 3-months compared to the first year post-discharge. This pattern was consistent across age groups and ABI subtypes. Reduced levels of functioning at discharge contributed considerably to increased mortality rates after adjustment for age and level of functioning at admission.Conclusion: In the present cohort of patients, a considerable mortality was observed post-discharge from comprehensive rehabilitation. Mortality rates dropped markedly after three months. This observation should be considered and investigated further

KW - Prognosis

KW - Rehabilitation

KW - acquired brain injury

KW - Mortality

M3 - Poster

T2 - 6th Annual Research Meeting

Y2 - 31 October 2023 through 31 October 2023

ER -