Abstract
BackgroundThe high occurrence and acute and chronic sequelae of traumatic brain injury (TBI) cause major healthcare and socioeconomic challenges. This study aimed to describe outcome, in-hospital healthcare consumption and in-hospital costs of patients with TBI.MethodsWe used data from hospitalised TBI patients that were included in the prospective observational CENTER-TBI study in three Dutch Level I Trauma Centres from 2015 to 2017. Clinical data was completed with data on in-hospital healthcare consumption and costs. TBI severity was classified using the Glasgow Coma Score (GCS). Patient outcome was measured by in-hospital mortality and Glasgow Outcome Score–Extended (GOSE) at 6 months. In-hospital costs were calculated following the Dutch guidelines for cost calculation.ResultsA total of 486 TBI patients were included. Mean age was 56.1 ± 22.4 years and mean GCS was 12.7 ± 3.8. Six-month mortality (4.2%–66.7%), unfavourable outcome (GOSE ≤ 4) (14.6%–80.4%) and full recovery (GOSE = 8) (32.5%–5.9%) rates varied from patients with mild TBI (GCS13–15) to very severe TBI (GCS3–5). Length of stay (8 ± 13 days) and in-hospital costs (€11,920) were substantial and increased with higher TBI severity, presence of intracranial abnormalities, extracranial injury and surgical intervention. Costs were primarily driven by admission (66%) and surgery (13%).ConclusionIn-hospital mortality and unfavourable outcome rates were rather high, but many patients also achieved full recovery. Hospitalised TBI patients show substantial in-hospital healthcare consumption and costs, even in patients with mild TBI. Because these costs are likely to be an underestimation of the actual total costs, more research is required to investigate the actual costs-effectiveness of TBI care.
Highlights
Recent estimates indicate that worldwide up to 69 million people a year sustain a traumatic brain injury (TBI). [15] The high incidence of TBI and the associated acute and chronic sequelae cause substantial healthcare and socio-economic challenges. [32] Available treatments are still largely unproven or unsatisfactory. [9, 15, 32, 75] Patients suffer from the medical consequences of TBI, which range from headache and fatigue to severe disabilities and even death [4, 14, 18, 59, 68]
Understanding and generalising the in-hospital costs of individual TBI patients from available literature remains difficult because methodological heterogeneity of TBI cost studies is high and study quality often inadequate [1, 30, 69]
A total of 486 patients with TBI were included in this study
Summary
Recent estimates indicate that worldwide up to 69 million people a year sustain a traumatic brain injury (TBI). [15] The high incidence of TBI and the associated acute and chronic sequelae cause substantial healthcare and socio-economic challenges. [32] Available treatments are still largely unproven or unsatisfactory. [9, 15, 32, 75] Patients suffer from the medical consequences of TBI, which range from headache and fatigue to severe disabilities and even death [4, 14, 18, 59, 68]. [15] The high incidence of TBI and the associated acute and chronic sequelae cause substantial healthcare and socio-economic challenges. The total global accompanying costs of around US$ 400 billion a year are a major challenge from a socioeconomic perspective [32], especially considering the fact that TBI-related healthcare costs are rising, while healthcare budgets remain limited [19]. Accurate insight in TBI-related costs is essential to substantiate research initiatives that aim to improve treatment efficiency. It guides policymakers on the rational allocation of resources without compromise of patient outcome. The high occurrence and acute and chronic sequelae of traumatic brain injury (TBI) cause major healthcare and socioeconomic challenges. This study aimed to describe outcome, in-hospital healthcare consumption and in-hospital costs of patients with TBI
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