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Surviving severe traumatic brain injury in Denmark: incidence and predictors of highly specialized rehabilitation

Authors Odgaard L, Poulsen I, Kammersgaard LP, Paaske Johnsen S, Feldbæk Nielsen J

Received 25 November 2014

Accepted for publication 22 January 2015

Published 20 March 2015 Volume 2015:7 Pages 225—234

DOI https://doi.org/10.2147/CLEP.S78141

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Henrik Toft Sørensen


Lene Odgaard,1 Ingrid Poulsen,2 Lars Peter Kammersgaard,2 Søren Paaske Johnsen,3 Jørgen Feldbæk Nielsen,1

1Hammel Neurorehabilitation Center and University Research Clinic, Aarhus University, Aarhus, Denmark; 2Department of Neurorehabilitation, TBI and Research Unit on Brain injury rehabilitation (RUBRIC), Glostrup Hospital, Copenhagen University, Copenhagen, Denmark; 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

Purpose: To identify all hospitalized patients surviving severe traumatic brain injury (TBI) in Denmark and to compare these patients to TBI patients admitted to highly specialized rehabilitation (HS-rehabilitation).
Patients and methods: Patients surviving severe TBI were identified from The Danish National Patient Registry and The Danish Head Trauma Database. Overall incidence rates of surviving severe TBI and incidence rates of admission to HS-rehabilitation after severe TBI were estimated and compared. Patient-related predictors of no admission to HS-rehabilitation among patients surviving severe TBI were identified using multivariable logistic regression.
Results: The average incidence rate of surviving severe TBI was 2.3 per 100,000 person years. Incidence rates of HS-rehabilitation were generally stable around 2.0 per 100,000 person years. Overall, 84% of all patients surviving severe TBI were admitted to HS-rehabilitation. Female sex, older age, and non-working status pre-injury were independent predictors of no HS-rehabilitation among patients surviving severe TBI.
Conclusion: The incidence rate of hospitalized patients surviving severe TBI was stable in Denmark and the majority of the patients were admitted to HS-rehabilitation. However, potential inequity in access to HS-rehabilitation may still be present despite a health care system based on equal access for all citizens.

Keywords: database, health care disparities, registries, validity
 

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