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Abstract Details

Long-Term Trajectories Following Severe Acute Brain Injury Requiring Mechanical Ventilation: A Mixed-methods Study to Assess Outcomes of Patients and Their Surrogate Decision-Makers
Neuro Trauma and Critical Care
P5 - Poster Session 5 (11:45 AM-12:45 PM)

SABI is the leading cause of disability worldwide. SDM of patients with SABI who require ICU care often have to make critical decisions about pursuing life-sustaining treatments while facing prognostic uncertainty. Long-term disability and high healthcare expenditures in patients with SABI who require long-term mechanical ventilation are common, outcomes of SDM are insufficiently explored.

To examine long-term neurological outcomes of patients with severe acute brain injury (SABI) who required mechanical ventilation, and mental health outcomes of their shared decision makers (SD) 12-18 months after SABI.

This is a mixed-methods study, prospectively collecting 1) quantitative data via a structured survey of 116 patients and SDM, assessing long-term outcomes, information about socioeconomic status, access to healthcare  2) qualitative data via semi-structured interviews of patients and SDM 12-24 months following SABI, exploring themes around ICU communication, satisfaction with critical decisions, and post-ICU recovery.

We will complement the analysis with a large, prospectively collected quantitative data gathered from adult patients who were admitted to the ICU with SABI (Traumatic Brain Injury, Acute Ischemic Stroke, Intracranial Hemorrhage, and Subarachnoid Hemorrhage) and required mechanical ventilation between September 2021-November 2021. This dataset contains detailed information about the patients’ clinical severity, therapy intensity level, intracranial pressure values, daily ventilator parameters during their ICU hospitalization, and the patients’ 6 months GOS-E.

Our primary outcome will be the GOS-E for the patients, and the PHQ-8, and PCL-5 for the SDM at 12-24 months after hospitalization. As our secondary outcomes, we will assess 1) socioeconomic status and financial impact, 2) perceptions of communication by the ICU team, how communication impacted critical decisions, satisfaction with these decisions, SDM understanding of prognosis 3) availability of resources (access to healthcare, health insurance, financial resources, caregivers, psychosocial support).

N/A (study in progress - results will be available by the time of the meeting)
Sarah Wahlster, MD
Dr. Wahlster has nothing to disclose.
James A. Town, MD (Harborview Medical Center) Dr. Town has nothing to disclose.
Nassim Matin, MD (Barrow Neurological Institute) Dr. Matin has nothing to disclose.
Natalie Smith Ms. Smith has nothing to disclose.
Adrienne James (University of Washington) Ms. JAMES has nothing to disclose.
Nicole Mazwi Nicole Mazwi has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Morrison Mahoney.
Robert Bonow Robert Bonow has nothing to disclose.
Abhijit Lele, MD,MBBS,Other Dr. Lele has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for LifeCenter Northwest .
Erin Kross, MD Dr. Kross has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for A PCORI funded grant. The institution of Dr. Kross has received research support from NIH.
Claire Creutzfeldt, MD The institution of Dr. Creutzfeldt has received research support from NINDS. The institution of Dr. Creutzfeldt has received research support from NINR.