Background Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. Objective Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. Methods Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. Results In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). Conclusions Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

中文翻译：

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创伤性脑损伤后一年获得康复的预测因素：一项欧洲前瞻性和多中心研究

背景虽然康复对创伤性脑损伤 (TBI) 的个体有益，但其中很大一部分在急性护理后没有得到充分的康复。目的 因此，这项前瞻性和多中心研究的目的是调查 TBI 患者受伤后一年内获得康复机会的预测因素。方法 使用来自一项大型欧洲研究 (CENTER-TBI) 的数据，包括 2014 年 12 月至 2017 年 12 月期间所有严重程度的 TBI（N = 4498 名患者）。参与者被分为在 TBI 后一年内进行康复治疗的患者和无法进行康复治疗的患者。潜在的预测因素包括社会人口因素、精神活性物质使用、受伤前病史、受伤相关因素以及与医疗、并发症和出院相关的因素。结果外伤后一年内，31.4%的患者接受了康复服务。女性（比值比 [OR] = 1.50）、完成的教育年数增加（OR = 1.05）、居住在北欧（OR = 1.62；参考：西欧）或南欧对康复机会有积极且显着的预测(OR = 1.74)、较低的院前格拉斯哥昏迷量表评分 (OR = 1.03)、较高的损伤严重程度评分 (OR = 1.01)、颅内 (OR = 1.33) 和颅外 (OR = 1.99) 手术以及颅外并发症 (OR = 1.77) ）。相比之下，显着的负面预测因素是缺乏伤前就业 (OR = 0.80)、居住在中欧和东欧 (OR = 0.42) 以及住院病房 (OR = 0.47；参考：入住重症监护病房) 或直接出院来自急诊室（OR = 0.24）。