A Population-Based Sex-Stratified Study to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome

Abstract

<h3>Research Objectives</h3> To understand how health status preceding traumatic brain injury (TBI) affects relative functional gain after inpatient rehabilitation. <h3>Design</h3> Population-based, sex-stratified, retrospective cohort study using health administrative data. <h3>Setting</h3> Inpatient rehabilitation in Ontario, Canada. <h3>Participants</h3> Patients 14 years or older (N=5,802; 63.4% males) admitted to inpatient rehabilitation within 1 year of a TBI-related acute caredischarge between April 1, 2008, and March 31, 2015. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Relative functional gain (RFG) in percentage. Health status prior to TBI was identified and internally validated using a data mining approach that categorized all International Classification of Diseases, 10th revision, codes for each patient. <h3>Results</h3> The average RFG was 52.8% +/- 27.6% among male patients and 51.6% +/- 27.1% among female patients. Sex-specific Bonferroni adjustedmultivariable linear regressions identified 10 factors of pre-injury health status related to neurology, emergency medicine, cardiology, psychiatry,geriatrics, and gastroenterology that were significantly associated with reduced RFG for male patients. Only 1 pre-injury health statuscategory, geriatrics, was significantly associated with RFG in female patients. <h3>Conclusions</h3> Pre-existing health conditions present up to 5 years preceding the TBI event were significantly associated with RFG. These findingsshould be considered when planning and executing interventions to maximize functional gain and to support an interdisciplinary approach. <h3>Author(s) Disclosures</h3> None.