Predictors of disability in adolescents and young adults with acquired brain injury after the acute phase

ABSTRACT

Aim

To develop and validate a prediction model for disability among young patients with acquired brain injury (ABI) after the acute phase.

Methods

Within a nationwide cohort of 446 15–30-year-old ABI-patients, we predicted disability in terms of Glasgow Outcome Scale – Extended (GOS-E) <7 12 months after baseline assessment in outpatient neurorehabilitation clinics. We studied 22 potential predictors covering demographic and medical factors, clinical tests, and self-reported fatigue and alcohol/drug consumption. The model was developed using multivariable logistic regression analysis and validated by 5-fold cross-validation and geographical validation. The model’s performance was assessed by receiver operating characteristic curves and calibration plots.

Results

Baseline assessment took place a median of 12 months post-ABI. Low GOS-E (range 1–8 (best)) and Functional Independence Measure (range 18–126 (best)) along with high mental fatigue (range 4–20 (worst)) predicted disability. The model showed high validity and performance with an area under the curve of 0.82 (95% confidence interval (CI) 0.77, 0.87) in the cross-validation and 0.81 (95% CI 0.73, 0.88) in the geographical validation.

Conclusion

We developed and validated a parsimonious model which effectively predicted disability. The model may be useful to guide decision-making in outpatient neurorehabilitation clinics treating young patients with ABI.

KEYWORDS:

• Fatigue
• functional independence measure
• glasgow outcome scale – extended
• outpatient
• prognosis
• rehabilitation needs

Supplementary data

Supplemental data for this article can be accessed on the publisher’s website

Disclosure of interest

The authors report no conflicts of interest.

Data availability statement

Data from DRUE are available through The Danish Clinical Quality Program – National Clinical Registries (https://www.rkkp.dk/in-english/) under standard conditions.

Additional information

Funding

The study was funded by the Danish Ministry of Health and the Capital Region of Denmark. The funding sources did not play any role in the design, data collection and analyses, preparation of the manuscript, or decision to publish.