Comorbidity in traumatic brain injury and risk of all-cause mortality, functional and financial burden: a decade-long population based cohort study

Information

  • Research Project
  • 9352700
  • ApplicationId
    9352700
  • Core Project Number
    R21HD089106
  • Full Project Number
    5R21HD089106-02
  • Serial Number
    089106
  • FOA Number
    RFA-HD-16-001
  • Sub Project Id
  • Project Start Date
    9/13/2016 - 7 years ago
  • Project End Date
    5/31/2018 - 6 years ago
  • Program Officer Name
    CRUZ, THERESA
  • Budget Start Date
    6/1/2017 - 7 years ago
  • Budget End Date
    5/31/2018 - 6 years ago
  • Fiscal Year
    2017
  • Support Year
    02
  • Suffix
  • Award Notice Date
    7/26/2017 - 6 years ago

Comorbidity in traumatic brain injury and risk of all-cause mortality, functional and financial burden: a decade-long population based cohort study

FUNDING OPPORTUNITY: Secondary analysis of existing databases in traumatic brain injury to explore outcomes relevant to medical rehabilitation (R21); RFA-HD-16-001 PI: COLANTONIO A PROJECT SUMMARY: Comorbidity is prevalent after traumatic brain injury (TBI) and across the spectrum of injury severity. It can be present at the time of injury, arise early after injury, or during hospitalization or inpatient rehabilitation. Long-term follow-up studies of individuals who had endured a TBI report that patients have numerous co-existing disorders. Nevertheless, our comprehension of the when (i.e., pre- or post-injury presentation), how (i.e., how the conditions affect the injured individual and their subsequent demand for health care services) and which (i.e., which comorbid conditions cause the greatest burden), with respect to excessive use of resources, functional outcomes, and all-cause mortality, remain unanswered. Larger population- based studies are necessary to address these research gaps. The proposed retrospective cohort study will utilize linked data of all patients with TBI diagnostic codes, derived from emergency departments (National Ambulatory Care Reporting System), acute care (Discharge Abstract Database), inpatient rehabilitation (National Rehabilitation System), community services and long-term care (Home Care Database), continuing care (Continuing Care Reporting System), and prescription data (Ontario Health Insurance Plan Claims Database) over a 10 year period. At least 35,000 acute care cases over a 10 year period form the basis of the longitudinal analysis. These data have undergone quality assessments and linkage by the Institute for Clinical Evaluation Sciences, a non-profit independent organization that carries out research to improve the effectiveness of health care services in Ontario, Canada. We hypothesize that acutely derived variables (i.e., age, intracranial injury, injury mechanism, injury severity, length of stay) ? currently the focus of most research efforts in TBI and comorbidity ? are not by themselves sufficient to accurately predict resource consumption, all-cause mortality, and functional outcomes in individuals with TBI, stratified by age and sex. We further hypothesize that an expanded set of factors and factor clusters including patient demographic, certain clinical (i.e., comorbid) disorders and social indices, will provide greater accuracy in predicting resource consumption, all-cause mortality and functional outcomes of TBI, and these clusters will be subject to change over time. This study of comorbidity in patients with TBI may lead to uncovering challenging multifaceted problems (i.e., frailty and patient complexity) that are currently not well defined but generally considered to be closely related to the presence of multiple comorbid disorders. October 2015

IC Name
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
  • Activity
    R21
  • Administering IC
    HD
  • Application Type
    5
  • Direct Cost Amount
    148331
  • Indirect Cost Amount
    11866
  • Total Cost
    160197
  • Sub Project Total Cost
  • ARRA Funded
    False
  • CFDA Code
    865
  • Ed Inst. Type
  • Funding ICs
    NICHD:160197\
  • Funding Mechanism
    Non-SBIR/STTR RPGs
  • Study Section
    ZHD1
  • Study Section Name
    Special Emphasis Panel
  • Organization Name
    UNIVERSITY HEALTH NETWORK
  • Organization Department
  • Organization DUNS
    208469486
  • Organization City
    TORONTO
  • Organization State
    ON
  • Organization Country
    CANADA
  • Organization Zip Code
    M5G 2M9
  • Organization District
    CANADA