A recent study led by Dr. Vincy Chan, Affiliate Scientist at The KITE Research Institute, examined how pre-existing health conditions affect inpatient rehabilitation outcomes after a traumatic brain injury. The team found that among adult patients in inpatient rehabilitation, conditions such as Alzheimer disease and dementia can reduce motor and cognitive recovery by up to 17%.
For the study, Dr. Chan and her team looked at de-identified data from all publicly funded hospitals in Ontario between April 2008 and March 2015. They discovered that close to 40,000 hospital visits during this time had a traumatic brain injury diagnosis. These injuries primarily result from a fall, motor vehicle collision, or being struck by an object or person.
Analyses of the data revealed that after receiving treatment, around one in six of patients were admitted to an inpatient rehabilitation bed. A third of these patients were females and on average, were 70 years of age.
The team looked for existing health conditions and events experienced by these individuals in the five years prior to their brain injury, then assessed the effect of these conditions on their motor and cognitive recovery during their rehabilitation stay.
Among male patients, ten categories of health status were found to be associated with reduced recovery, including Alzheimer disease and dementia (17% reduction), mental health disorders (5% reduction), and conditions and events commonly experienced by older adults such as osteoporosis and falls (5% reduction). All of these factors were common among male and female patients; however, only conditions and events commonly experienced by older adults significantly affected females (5% reduction).
“While our study shows that pre-existing health conditions reduce the extent of functional gain during rehabilitation, it is important to emphasize that patients with brain injuries still make significant progress during their rehabilitation stay,” says Dr. Chan.
The number of older adults experiencing traumatic brain injuries is rapidly increasing. In the coming decades, more patients with pre-existing health conditions will be admitted to a rehabilitation hospital after a brain injury, and providers need to be prepared for patients with these conditions.
“More research to understand how pre-existing conditions affect rehabilitation interventions will help us maximize the benefits of rehabilitation for all patients that experience brain injury,” says Dr. Chan.
This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD089106), the Canada Research Chairs Program, and the Toronto Rehab Foundation. V Chan holds an Early Career Research Award from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R03HD104206). A Colantonio holds a Tier 1 Canada Research Chair in Traumatic Brain Injury in Underserved Populations.
Chan V, Sutton M, Mollayeva T, Escobar MD, Hurst M, Colantonio A. Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study. Arch Phys Med Rehabil. 2020 Sep. doi: 10.1016/j.apmr.2020.05.017.
Dr. Vincy Chan, Affiliate Scientist at The KITE Research Institute and the lead author of the study.