Abstract Details

Title 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

Topic Neuro Trauma and Critical Care

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-006

Background

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.

Objective 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.

Design/Methods

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).

Results N/A (study in progress - results will be available by the time of the meeting)

Conclusions N/A

Authors/Disclosures
Sarah Wahlster, MD PRESENTER	Dr. Wahlster has nothing to disclose.
	No disclosure on file
Nassim Matin, MD (Barrow Neurological Institute)	Dr. Matin has nothing to disclose.
Natalie Smith	Ms. Smith has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Abhijit Lele	No disclosure on file
	No disclosure on file
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.