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Updated: Jun 25, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Identifying pre- and posttraumatic brain injury pathways with a multidomain sequence analysis: a retrospective cohort
Fanny Crozes1, Xavier de Boissezon2, Romain Demeulemeester1
1Health Economic Unit, Department of Medical Information, University Hospital Center of Toulouse, 2 rue Viguerie, 31059 Toulouse, France; EQUITY Research Team, Center for Epidemiology and Research in Population Health, Inserm UMR 1295, University Toulouse, 37 Allées Jules Guesde, 31000 Toulouse, France.
Traumatic brain injury (TBI) care pathways are diverse, varying significantly by age and individual factors. Understanding these patient journeys is key to developing personalized, coordinated care strategies for better outcomes.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Traumatic brain injury (TBI) presents a significant public health challenge with high mortality and long-term disability rates.
- Current understanding of patient care trajectories before and after TBI is limited, hindering optimized care development.
Purpose of the Study:
- To delineate the care pathways following TBI.
- To identify factors influencing these patient trajectories.
- To inform the creation of coordinated and improved TBI care strategies.
Main Methods:
- Retrospective cohort study utilizing data from Toulouse University Hospital and French National Health Data System (2014-2018).
- Identification of TBI patients via ICD-10 codes, with healthcare trajectories reconstructed for 2 years pre- and post-injury.
- Multidomain sequence analysis (care unit, outpatient care, mental health) and multinomial logistic regression to analyze determinants of care trajectories.
Main Results:
- Six distinct care trajectories identified, with 3 specific to age groups (young individuals and seniors).
- Younger individuals (10-52 years) showed trajectories from low-complexity to high healthcare needs linked to mental health issues.
- Seniors (53-107 years) exhibited pathways reflecting autonomy loss, rehabilitation needs, and psychotropic medication use.
- Mental health fragility and hospitalization needs were key discriminators of complex trajectories in both age groups.
- Younger group clustering influenced by socioeconomic deprivation; seniors by sex and comorbidities.
Conclusions:
- TBI care pathways are heterogeneous, necessitating age-specific and personalized care strategies.
- Understanding patient trajectories aids in early identification of vulnerable individuals and targeted interventions.
- This research supports improved equity and continuity of care for TBI patients and offers a model for other complex conditions.
