Prevalence, Patterns, and Predictors of Multimorbidity in Adults With Acquired Brain Injury at Admission to Staged Community-Based Rehabilitation.
Hayley M Jackson, Lakkhina Troeung, Angelita Martini
PMID 33543112WHAT IT FOUND
72.2% of adults entering staged community brain injury rehabilitation had a chronic condition, and 35.4% had conditions across two or more body systems.
Older age was the only factor linked to conditions affecting multiple body systems.
Key findings
01Comorbidity was recorded in 190 of 263 participants (72.2%), multimorbidity across 2 or more domains in 93 of 263 (35.4%), and multimorbidity across 3 or more domains in 32 of 263 (12.2%).
02Participants with nontraumatic brain injury had significantly higher prevalence of comorbidity (142 of 187, 75.9% versus 48 of 76, 63.2%), multimorbidity across 2 or more domains (75 of 187, 40.1% versus 18 of 76, 23.7%), and multimorbidity across 3 or more domains (28 of 187, 15.0% versus 4 of 76, 5.3%) than participants with traumatic brain injury.
03After accounting for sex, marital status and brain injury diagnosis, increasing age was the only factor linked to higher odds of having chronic conditions, with reported odds ratios of 1.04 for one or more domains and 1.05 for two or more domains.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was a convenience sample from one service in Western Australia, so it may not represent all adults with acquired brain injury. Only people with complete data were included, and 8 were missing demographic data for the regression, leaving 255. Conditions were counted equally regardless of severity or combination, so the study does not show how much each condition affected the person. Data came from routine clinical records, so some conditions may not have been recorded; the prevalence may be underestimated. The study could not tell whether chronic conditions existed before or after the brain injury. The body-system classification was broad and did not separate acquired from nonacquired or communicable from noncommunicable conditions. The study is descriptive and cannot show that any rehabilitation service or intervention changed outcomes.
The easy way to misread this
Do not read the higher multimorbidity in nontraumatic brain injury as proof that the injury type caused more conditions. The study counted conditions recorded at admission and could not tell whether they existed before or after the brain injury.