Cohort profile: the Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT), Western Australia, 1991–2020

Abstract

Purpose Transition back into the community following acute management of acquired brain injury (ABI) is a critical part of recovery. Post-acute rehabilitation and transitional care can significantly improve outcomes. The Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT) is a novel whole-population cohort formed to better understand the needs of individuals with ABI receiving post-acute rehabilitation and disability services in Western Australia (WA), and to improve their outcomes. To do this a unique combination of (1) internal clinical/rehabilitation data, and (2) externally linked health data from the WA Data Linkage System was used, including hospitalisations, emergency department presentations, mental health service use and death records, to measure longitudinal needs and outcomes of individuals with ABI over 29 years, making this the largest, most diverse post-acute ABI cohort in Australia to date. Participants Whole-population cohort of individuals (n=1011) with an ABI who received post-acute community-based neurorehabilitation or disability support services through Brightwater Care Group from 1991 to 2020. Findings to date Comprehensive baseline demographic, clinical and rehabilitation data, outcome measures and linked health data have been collected and analysed. Non-traumatic brain injury (eg, stroke, hypoxia) was the main diagnostic group (54.9%, n=555), followed by traumatic brain injury (34.9%, n=353) and eligible neurological conditions (10.2%, n=103). Mean age at admission was 45.4 years, and 67.5% were men (n=682). The cohort demonstrated significant heterogeneity, socially and clinically, with differences between ABI groups across a number of domains. Future plans ABI-RESTaRT is a dynamic whole-population cohort that will be updated over time as individuals enrol in the service. Future analyses will assess longitudinal brain injury outcomes, the changing health and social needs of individuals with ABI and evaluate and inform post-acute services to best support these individuals. Registration This cohort is not linked to a clinical trial, and is not registered.

Rehabilitation outcomes at discharge from staged community-based brain injury rehabilitation: A retrospective cohort study (ABI-RESTaRT), Western Australia, 2011–2020

“…ABI-RESTaRT is a retrospective whole-population cohort study of all individuals aged 18–65 years who received post-acute care through Brightwater Care Group from inception in 1991 to 31 December 2020 ( n = 1,011) ( 18 ). Inclusion criteria were English speaking and a primary diagnosis of TBI, NTBI, or eligible neurologic condition, defined by Australian Rehabilitation Outcomes Center impairment codes ( 19 ).…”

“…Demographic and clinical variables were extracted from EMRs and linked Hospital Morbidity Data Collection (HMDC) and Emergency Department Data Collection (EDDC) records from the WA Data Linkage System ( 20 ). Full details are presented elsewhere ( 18 ).…”

“…As part of the ABI-RESTaRT ( 18 ) research program, this study evaluates change in functional independence, psychosocial functioning, and goal attainment, in a cohort of 323 adults with ABI who received SCBIR in WA, 2011–2020, compared against a control cohort of 312 adults with ABI admitted across three non-rehabilitation programs over the same period. Predictors of goal attainment at discharge are also investigated to inform rehabilitation planning.…”

Sequelae of neurological infection: management in primary care

“…Specifically, an episode of CNS infection can lead to an ABI, wherein neuroglial cell damage occurs due to a combination of infection directly and the associated immune response 8 . ABI can lead to functional disability in survivors, and globally millions suffer from long‐term physical, cognitive and psychosocial sequelae secondary to neurological infection 9 .…”

“…[5][6][7] Specifically, an episode of CNS infection can lead to an ABI, wherein neuroglial cell damage occurs due to a combination of infection directly and the associated immune response. 8 ABI can lead to functional disability in survivors, and globally millions suffer from long-term physical, cognitive and psychosocial sequelae secondary to neurological infection. 9 In the UK, multicentre studies have shown reduced quality of life following episodes of meningitis and encephalitis, with long-term mental health issues and neurocognitive dysfunction being common.…”