Rehabilitation and Outcomes After Complicated Vs Uncomplicated Mild TBI: Results from the CENTER-TBI Study

aut.relation.issue1en_NZ
aut.relation.journalBMC Health Services Researchen_NZ
aut.relation.volume22en_NZ
aut.researcherFeigin, Valery
dc.contributor.authorHowe, EIen_NZ
dc.contributor.authorZeldovich, Men_NZ
dc.contributor.authorAndelic, Nen_NZ
dc.contributor.authorvon Steinbuechel, Nen_NZ
dc.contributor.authorFure, SCRen_NZ
dc.contributor.authorBorgen, IMHen_NZ
dc.contributor.authorForslund, MVen_NZ
dc.contributor.authorHellstrøm, Ten_NZ
dc.contributor.authorSøberg, HLen_NZ
dc.contributor.authorSveen, Uen_NZ
dc.contributor.authorRasmussen, Men_NZ
dc.contributor.authorKleffelgaard, Ien_NZ
dc.contributor.authorTverdal, Cen_NZ
dc.contributor.authorHelseth, Een_NZ
dc.contributor.authorLøvstad, Men_NZ
dc.contributor.authorLu, Jen_NZ
dc.contributor.authorArango-Lasprilla, JCen_NZ
dc.contributor.authorTenovuo, Oen_NZ
dc.contributor.authorAzouvi, Pen_NZ
dc.contributor.authorDawes, Hen_NZ
dc.contributor.authorRoe, Cen_NZ
dc.contributor.authorÅkerlund, Cen_NZ
dc.contributor.authorAmrein, Ken_NZ
dc.contributor.authorAndreassen, Len_NZ
dc.contributor.authorAnke, Aen_NZ
dc.contributor.authorAntoni, Aen_NZ
dc.contributor.authorAudibert, Gen_NZ
dc.contributor.authorAzzolini, MLen_NZ
dc.contributor.authorBartels, Ren_NZ
dc.contributor.authorBarzó, Pen_NZ
dc.contributor.authorBeauvais, Ren_NZ
dc.contributor.authorBeer, Ren_NZ
dc.contributor.authorBellander, BMen_NZ
dc.contributor.authorBelli, Aen_NZ
dc.contributor.authorBenali, Hen_NZ
dc.contributor.authorBerardino, Men_NZ
dc.contributor.authorBeretta, Len_NZ
dc.contributor.authorBlaabjerg, Men_NZ
dc.contributor.authorBragge, Pen_NZ
dc.contributor.authorBrazinova, Aen_NZ
dc.contributor.authorBrinck, Ven_NZ
dc.contributor.authorBrooker, Jen_NZ
dc.contributor.authorBrorsson, Cen_NZ
dc.contributor.authorBuki, Aen_NZ
dc.contributor.authorBullinger, Men_NZ
dc.contributor.authorCabeleira, Men_NZ
dc.contributor.authorCaccioppola, Aen_NZ
dc.contributor.authorCalappi, Een_NZ
dc.contributor.authorCalvi, MRen_NZ
dc.contributor.authorCameron, Pen_NZ
dc.contributor.authorCarbayo Lozano, Gen_NZ
dc.contributor.authorCarbonara, Men_NZ
dc.contributor.authorCavallo, Sen_NZ
dc.contributor.authorChevallard, Gen_NZ
dc.contributor.authorChieregato, Aen_NZ
dc.contributor.authorCiterio, Gen_NZ
dc.contributor.authorClusmann, Hen_NZ
dc.contributor.authorCoburn, Men_NZ
dc.contributor.authorColes, Jen_NZ
dc.contributor.authorCooper, JDen_NZ
dc.contributor.authorCorreia, Men_NZ
dc.contributor.authorČović, Aen_NZ
dc.contributor.authorCurry, Nen_NZ
dc.contributor.authorCzeiter, Een_NZ
dc.contributor.authorCzosnyka, Men_NZ
dc.contributor.authorDahyot-Fizelier, Cen_NZ
dc.contributor.authorDark, Pen_NZ
dc.contributor.authorDe Keyser, Ven_NZ
dc.contributor.authorDegos, Ven_NZ
dc.contributor.authorDella Corte, Fen_NZ
dc.contributor.authorden Boogert, Hen_NZ
dc.contributor.authorDepreitere, Ben_NZ
dc.contributor.authorĐilvesi, Đen_NZ
dc.contributor.authorDixit, Aen_NZ
dc.contributor.authorDonoghue, Een_NZ
dc.contributor.authorDreier, Jen_NZ
dc.contributor.authorDulière, GLen_NZ
dc.contributor.authorErcole, Aen_NZ
dc.contributor.authorEsser, Pen_NZ
dc.contributor.authorEzer, Een_NZ
dc.contributor.authorFabricius, Men_NZ
dc.contributor.authorFeigin, VLen_NZ
dc.contributor.authorFoks, Ken_NZ
dc.contributor.authorFrisvold, Sen_NZ
dc.contributor.authorFurmanov, Aen_NZ
dc.contributor.authorGagliardo, Pen_NZ
dc.contributor.authorGalanaud, Den_NZ
dc.contributor.authorGantner, Den_NZ
dc.contributor.authorGao, Gen_NZ
dc.contributor.authorGeorge, Pen_NZ
dc.contributor.authorGhuysen, Aen_NZ
dc.contributor.authorGiga, Len_NZ
dc.contributor.authorGlocker, Ben_NZ
dc.contributor.authorGolubovic, Jen_NZ
dc.contributor.authorGomez, PAen_NZ
dc.contributor.authorGratz, Jen_NZ
dc.contributor.authorGravesteijn, Ben_NZ
dc.contributor.authorGrossi, Fen_NZ
dc.contributor.authorGruen, RLen_NZ
dc.contributor.authorGupta, Den_NZ
dc.date.accessioned2023-01-10T00:46:15Z
dc.date.available2023-01-10T00:46:15Z
dc.date.copyright2022en_NZ
dc.date.issued2022en_NZ
dc.description.abstractBackground: Despite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and investigate factors associated with functional outcome, symptom burden, and TBI-specific health-related quality of life (HRQOL) up to six months after injury. Methods: Patients (n = 1379) with mTBI from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study who reported whether they received rehabilitation services during the first six months post-injury and who participated in outcome assessments were included. Functional outcome was measured with the Glasgow Outcome Scale – Extended (GOSE), symptom burden with the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and HRQOL with the Quality of Life after Brain Injury – Overall Scale (QOLIBRI-OS). We examined whether transition of care (TOC) pathways, receiving rehabilitation services, sociodemographic (incl. geographic), premorbid, and injury-related factors were associated with outcomes using regression models. For easy comparison, we estimated ordinal regression models for all outcomes where the scores were classified based on quantiles. Results: Overall, 43% of patients with complicated and 20% with uncomplicated mTBI reported receiving rehabilitation services, primarily in physical and cognitive domains. Patients with complicated mTBI had lower functional level, higher symptom burden, and lower HRQOL compared to uncomplicated mTBI. Rehabilitation services at three or six months and a higher number of TOC were associated with unfavorable outcomes in all models, in addition to pre-morbid psychiatric problems. Being male and having more than 13 years of education was associated with more favorable outcomes. Sustaining major trauma was associated with unfavorable GOSE outcome, whereas living in Southern and Eastern European regions was associated with lower HRQOL. Conclusions: Patients with complicated mTBI reported more unfavorable outcomes and received rehabilitation services more frequently. Receiving rehabilitation services and higher number of care transitions were indicators of injury severity and associated with unfavorable outcomes. The findings should be interpreted carefully and validated in future studies as we applied a novel analytic approach. Trial registration: ClinicalTrials.gov NCT02210221.en_NZ
dc.identifier.citationBMC Health Services Research 22, 1536 (2022). https://doi.org/10.1186/s12913-022-08908-0
dc.identifier.doi10.1186/s12913-022-08908-0en_NZ
dc.identifier.issn1472-6963en_NZ
dc.identifier.issn1472-6963en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/15785
dc.publisherBioMed Central
dc.relation.urihttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08908-0
dc.rights.accessrightsOpenAccessen_NZ
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectRehabilitation; Mild TBI; PROM
dc.titleRehabilitation and Outcomes After Complicated Vs Uncomplicated Mild TBI: Results from the CENTER-TBI Studyen_NZ
dc.typeJournal Article
pubs.elements-id488099
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Faculty of Health & Environmental Sciences
pubs.organisational-data/AUT/Faculty of Health & Environmental Sciences/School of Clinical Sciences
pubs.organisational-data/AUT/Faculty of Health & Environmental Sciences/School of Clinical Sciences/Psychology & Neuroscience Department
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