Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation

Objectives: To describe the prevalence, patterns, and predictors of multimorbidity in adults with an acquired brain injury (ABI) on presentation to a community-based neurorehabilitation service. Design: Retrospective cohort study using routinely collected admissions and clinical data. Setting: Commu...

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Main Authors: Hayley M. Jackson, BA, Lakkhina Troeung, PhD, Angelita Martini, PhD
Format: Article
Language:English
Published: Elsevier 2020-12-01
Series:Archives of Rehabilitation Research and Clinical Translation
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S259010952030077X
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author Hayley M. Jackson, BA
Lakkhina Troeung, PhD
Angelita Martini, PhD
author_facet Hayley M. Jackson, BA
Lakkhina Troeung, PhD
Angelita Martini, PhD
author_sort Hayley M. Jackson, BA
collection DOAJ
description Objectives: To describe the prevalence, patterns, and predictors of multimorbidity in adults with an acquired brain injury (ABI) on presentation to a community-based neurorehabilitation service. Design: Retrospective cohort study using routinely collected admissions and clinical data. Setting: Community-based neurorehabilitation. Participants: Individuals (N=263) with non-traumatic brain injury (NTBI; n=187 [71.1%]) versus traumatic brain injury (TBI; n=76 [28.9%]). Interventions: Not applicable. Main Outcome Measures: Comorbidity was defined as the co-occurrence of at least one chronic condition in conjunction with a primary diagnosis of ABI. Multimorbidity was defined as the co-occurrence of 2 or more chronic conditions across 2 or more body systems, in conjunction with a primary diagnosis of ABI. Results: Comorbidity was present in 72.2% of participants overall, whereas multimorbidity was present in 35.4% of the cohort. The prevalence of comorbidity (76% vs 63%; P=.036) and multimorbidity (40% vs 24%; P=.012) was higher in NTBI compared with participants with TBI. Participants with NTBI had a higher prevalence of physical health multimorbidities, including cardiovascular (44% vs 6%; P<.001) and endocrine (34% vs 10%; P=.002) disease, whereas participants with TBI had a higher prevalence of mental health conditions (79% vs 48%; P<.001). Depression (36.3%) and hypertension (25.8%) were the most common diagnoses. Increasing age was the only significant predictor of multimorbidity. Conclusions: Most participants experienced multimorbidity. Effective management of multimorbidity should be included as part of individual rehabilitation for ABI and planning of resource allocation and service delivery. The results of this study can help guide the provision of treatment and services for individuals with ABI in community-based rehabilitation. Our study highlights access to mental health, cardiovascular, endocrine, and neurology services as essential components of rehabilitation for ABI.
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spelling doaj.art-ac18bcdf4146494f9dfff476007f11ee2022-12-21T22:03:01ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952020-12-0124100089Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based RehabilitationHayley M. Jackson, BA0Lakkhina Troeung, PhD1Angelita Martini, PhD2Brightwater Care Group, Brightwater Research Centre, Perth, Australia; School of Psychological Science, University of Western Australia, Crawley, AustraliaBrightwater Care Group, Brightwater Research Centre, Perth, AustraliaBrightwater Care Group, Brightwater Research Centre, Perth, Australia; Corresponding author Angelita Martini, PhD, Director, Brightwater Research Centre, 355 Scarborough Beach Rd, Osborne Park, WA 6017 Australia.Objectives: To describe the prevalence, patterns, and predictors of multimorbidity in adults with an acquired brain injury (ABI) on presentation to a community-based neurorehabilitation service. Design: Retrospective cohort study using routinely collected admissions and clinical data. Setting: Community-based neurorehabilitation. Participants: Individuals (N=263) with non-traumatic brain injury (NTBI; n=187 [71.1%]) versus traumatic brain injury (TBI; n=76 [28.9%]). Interventions: Not applicable. Main Outcome Measures: Comorbidity was defined as the co-occurrence of at least one chronic condition in conjunction with a primary diagnosis of ABI. Multimorbidity was defined as the co-occurrence of 2 or more chronic conditions across 2 or more body systems, in conjunction with a primary diagnosis of ABI. Results: Comorbidity was present in 72.2% of participants overall, whereas multimorbidity was present in 35.4% of the cohort. The prevalence of comorbidity (76% vs 63%; P=.036) and multimorbidity (40% vs 24%; P=.012) was higher in NTBI compared with participants with TBI. Participants with NTBI had a higher prevalence of physical health multimorbidities, including cardiovascular (44% vs 6%; P<.001) and endocrine (34% vs 10%; P=.002) disease, whereas participants with TBI had a higher prevalence of mental health conditions (79% vs 48%; P<.001). Depression (36.3%) and hypertension (25.8%) were the most common diagnoses. Increasing age was the only significant predictor of multimorbidity. Conclusions: Most participants experienced multimorbidity. Effective management of multimorbidity should be included as part of individual rehabilitation for ABI and planning of resource allocation and service delivery. The results of this study can help guide the provision of treatment and services for individuals with ABI in community-based rehabilitation. Our study highlights access to mental health, cardiovascular, endocrine, and neurology services as essential components of rehabilitation for ABI.http://www.sciencedirect.com/science/article/pii/S259010952030077XBrain injuriesComorbidityMultimorbidityRehabilitation
spellingShingle Hayley M. Jackson, BA
Lakkhina Troeung, PhD
Angelita Martini, PhD
Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation
Archives of Rehabilitation Research and Clinical Translation
Brain injuries
Comorbidity
Multimorbidity
Rehabilitation
title Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation
title_full Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation
title_fullStr Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation
title_full_unstemmed Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation
title_short Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation
title_sort prevalence patterns and predictors of multimorbidity in adults with acquired brain injury at admission to staged community based rehabilitation
topic Brain injuries
Comorbidity
Multimorbidity
Rehabilitation
url http://www.sciencedirect.com/science/article/pii/S259010952030077X
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