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P.116 Days at home after traumatic brain injury: moving beyond mortality to evaluate patient-centered outcomes using population health data

Published online by Cambridge University Press:  24 May 2024

AK Malhotra
Affiliation:
(Toronto)*
AB Nathens
Affiliation:
(Toronto)
H Shakil
Affiliation:
(Toronto)
RH Jaffe
Affiliation:
(Toronto)
A Essa
Affiliation:
(Toronto)
F Mathieu
Affiliation:
(Toronto)
J Badhiwala
Affiliation:
(Toronto)
K Thorpe
Affiliation:
(Toronto)
AV Kulkarni
Affiliation:
(Toronto)
CD Witiw
Affiliation:
(Toronto)
JR Wilson
Affiliation:
(Toronto)
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Abstract

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Background: Despite the utility of administrative health data, there remains a lack of patient-centered outcome measures to meaningfully capture morbidity after traumatic brain injury (TBI). We sought to characterize and validate days at home (DAH) as a feasible measure to assess population-level moderate to severe TBI (msTBI) outcomes and health resource utilization. Methods: We utilized linked health administrative data sources to identify adults with msTBI patients presenting to trauma centers in Ontario injured between 2009-2021. DAH at 180 days reflects the total number of days spent alive and at home excluding the days spent institutionalized in acute care, rehabilitation, inpatient mental health settings or post-acute readmissions. Construct and predictive validity were determined; we additionally estimated minimally important difference (MID) in DAH180days. Results: There were 6340 patients that met inclusion criteria. Median DAH180days were 70 days (interquartile range 0-144). Increased health resource utilization at baseline, older age, increasing cranial injury severity and major extracranial injuries were significantly associated with fewer DAH180days. DAH180days was correlated to DAH counts at 1-3 years. The average MID estimate from anchor-based and distribution-based methods was 18 days. Conclusions: We introduce DAH180days as a feasible and sufficiently responsive patient-centered outcome measure with construct, predictive and face validity in an msTBI population.

Type
Abstracts
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation