The impact of acquired brain damage in terms of epidemiology, economics and loss in quality of life

Abstract

BackgroundPatients with acquired brain damage (ABD) have suffered a brain lesion that interrupts vital development in the physical, psychological and social spheres. Stroke and traumatic brain injury (TBI) are the two main causes. The objectives of this study were to estimate the incidence and prevalence of ABD in the population of the Basque Country and Navarre in 2008, to calculate the associated cost of the care required and finally to assess the loss in health-related quality of life.MethodsOn the one hand, a cross-sectional survey was carried out, in order to estimate the incidence of ABD and its consequences in terms of costs and loss in quality of life from the evolution of a sample of patients diagnosed with stroke and TBI. On the other hand, a discrete event simulation model was built that enabled the prevalence of ABD to be estimated. Finally, a calculation was made of the formal and informal costs of ABD in the population of the Basque Country and Navarre (2,750,000 people).ResultsThe cross-sectional study showed that the incidences of ABD caused by stroke and TBI were 61.8 and 12.5 cases per 100,000 per year respectively, while the overall prevalence was 657 cases per 100,000 people. The SF-36 physical and mental component scores were 28.9 and 44.5 respectively. The total economic burden was calculated to be 382.14 million euro per year, distributed between 215.27 and 166.87 of formal and informal burden respectively. The average cost per individual was 21,040 € per year.ConclusionsThe main conclusion of this study is that ABD has a high impact in both epidemiological and economic terms as well as loss in quality of life. The overall prevalence obtained is equivalent to 0.7% of the total population. The substantial economic burden is distributed nearly evenly between formal and informal costs. Specifically, it was found that the physical dimensions of quality of life are the most severely affected. The prevalence-based approach showed adequate to estimate the population impact of ABD and the resources needed to compensate the disability.

The Cost of Materials for Intra-Arterial Thrombectomy

“…It is difficult to evaluate the long-term financial impact of brain damage. Informal care costs due to disability represent a largely hidden burden on society 18,19 . Moreover, patients and their families may also have health-related costs following stroke and these are not emphasized in economic studies 29 .…”

“…This direct cost is not negligible when compared to the mean cost of hospitalization and rehabilitation. For example, the average cost per individual has been evaluated at 21,040 euro per year after a stroke in a recent Spanish study 18 . To evaluate the cost-effectiveness of a treatment, we have to take into account the global associated cost of care and loss in health-related quality of life 18 .…”

“…Cost-effectiveness studies concerning primary 4 and secondary prevention 5 , diagnostic testing 6 , thrombolysis [7][8][9][10][11][12][13][14][15] , rehabilitation 16 , management systems 17 and also the informal care costs of long-term care after stroke 18,19 have been published. Few studies have explored the cost-effectiveness of mechanical thrombectomy [20][21][22] .…”

E2Rebot: A robotic platform for upper limb rehabilitation in patients with neuromotor disability

“…1 This condition can be temporary or permanent, and it is the origin of a disability in the functionality and the psycho-social adjustment that directly influences the quality of life of those affected. 2 It produces an interruption in the life development in psychological, physical, and social aspects, 3 and it is one of the most frequent causes of disability and death in the 1 world. 4 The World Health Organization estimates that almost half of the world's population could suffer an injury of ABI, and the National Center for Injury Prevention and Control estimates that around 2% of the US population suffers from a disability as a result of an ABI as a consequence of a trauma.…”

Efecto de un programa de actividad físico deportiva sobre la salud de personas con daño cerebral adquirido en fase crónica

“…Se han estudiado en profundidad las variables que influyen en la mejora de la CVRS tras un DCA, encontrando determinantes la severidad de la lesión (Hu, Feng, Fan, Xiong, y Huang, 2012;Ilmer et al, 2016), los costes económicos (Lopez-Bastida et al, 2012;Mar et al, 2011), la capacidad funcional (movilidad) (C. Chen et al, 2015;Gillard et al, 2015;Hong, 2015;Mar et al, 2011;Min y Min, 2015;Walsh, Galvin, Loughnane, Macey, y Horgan, 2014;Williamson et al, 2013), los síntomas depresivos y el estado de ánimo (Arango-Lasprilla, Krch, Drew, De Los Reyes Aragon, y Stevens, 2012; Boosman et al, 2015;Di Battista, Godfrey, Soo, Catroppa, y Anderson, 2014;Grauwmeijer, Heijenbrok-Kal, y Ribbers, 2014;Haagsma et al, 2015;Walsh et al, 2014;Williamson et al, 2013), el nivel cognitivo (Arango-Lasprilla et al, 2012;Boosman et al, 2015;C. Chen et al, 2015;Sasse et al, 2013), el grado de participación en las actividades (C. Chen et al, 2015;Chou, 2015;Faulkner et al, 2015) y el soporte social (Arango-Lasprilla et al, 2012).…”