Early predictors of long-term participation in patients with severe acquired traumatic injury discharged from Intensive Rehabilitation Unit

bacKGrouNd: participation represents the most relevant indicator of successful functioning after a severe traumatic brain injury (stbi), since it correlates with a higher perceived quality of life by patients, their families, and healthcare professionals. Nevertheless, studies on italian population are lacking. aiM: the aim of this study was to evaluate the long-term participation and its early predictors in patients after a stbi. dEsiGN: this paper is an observational retrospective single-site study with long-term follow-up. sEttiNG: the intensive rehabilitation units (iru) of the irccs don Gnocchi foundation, florence, italy. populatioN: the population included adults who were admitted to the iru after a stbi from august 2012 to May 2020 and who underwent a longitudinal follow-up between september 2021 and april 2022. MEthods: patients were contacted by a phone interview including participation assessment using the community integration Questionnaire (ciQ). When the patients were unable to respond, the caregiver was interviewed. Early predictors of long-term participation at admission and discharge from the iru were assessed by a univariate and a multivariate analysis. rEsults: among one hundred and forty-nine eligible patients, 3 died during their iru stay, 35 patients were lost at the follow-up, 5 refused to participate in the interview and 46 died between discharge and follow-up. sixty patients (men: 48 [80%]; age: 53.8 [iQr: 34.1] years; time postonset [tpo]: 36.5 [iQr: 22] days; education level: 8 [iQr: 5] years; mean time event-follow-up: 5.8 [iQr: 3.5] years) were included. the total ciQ score was 11 (0-28): home integration score 4 (0-10), social integration 6 (0-12) and productive activity 0 (0-6). among 33 patients who worked or studied before the event, 19 (57.6%) returned to their previous activities. only a younger age was associated with a better long-term participation both at admission (b=-0.210, p<0.001, r2=0.307) and at discharge (b=-0.173, p<0.001, r2=0.398). coNclusioNs: this study reveals that under the same umbrella label of stbi there are patients whose trajectories of long-term participa- tion recovery are extremely heterogeneous. further studies on larger samples are needed to identify patients with better participation recovery profiles, to customize their rehabilitation pathway. cliNical rEhabilitatioN iMpact: the present study provides relevant information to help clinicians in giving accurate information to caregivers and drawing adequate rehabilitation pathways