Disclosures: Lynne F Turner-Stokes, DM FRCP MBE: No disclosure data submitted.

Objective: To estimate potential life-time savings in the cost of ongoing care following rehabilitation for complex hypoxic brain injury (HBI), comparing three groups of dependency.

Design: Analysis of prospectively collected clinical data from the UKROC national clinical database.

Setting: A specialist (Levels 1 and 2) rehabilitation centres in England (n=67).

Participants: All HBI episodes with complete data between 2012-2018 (n=1094).

Interventions: Inpatient specialist rehabilitation

Main Outcome Measures: Recorded on admission and discharge, the Northwick Park Dependency and Care Needs Assessment (NPDS/NPCNA) calculates the savings in ongoing care-costs in the community. Life expectancy was computed in five groups defined by FIM scores at discharge according to the US Life Expectancy Project (www.lifeexpectancy.org) Percentage reduction in predicted life expectancy following HBI was calculated using US mortality figures applied to national UK projected life expectancy figures. Life-time savings (‘savings in ongoing care costs/year × remaining years of life’) were analysed in three groups of dependency, based on NPDS scores on admission (High, Medium and Low).

Results: Mean age 50.5 (sd15) years; mean length of stay 106 (±sd73) days. Overall mean annual savings in care costs were £19,746 (95%CI £27,299, £30,686) per patient and mean remaining life expectancy 19.5 (95%CI 18.8, 20.2) years. Estimated life-time savings in ongoing care-costs were £433,020 (95%CI £366,358, £502,271) per patient, totaling over £474 million for the analysed population (n=1094). Life expectancy was shortest in the High-dependency group at 17.1 (±11.2) years (Medium 25.2 (±13.1) and Low 26.9 (±11.9)). However, the cost savings were larger, so the mean life-time savings were greatest in the High- and Medium-dependency groups (£529,667 and £468,886 respectively), compared with the Low-dependency group (£48,571).

Conclusions: Although outcomes from HBI are generally less favourable than other forms of BI (eg Trauma), even very severely dependent patients can make functional gains from specialist rehabilitation, leading to substantial savings in ongoing care-costs when computed over a life-time.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/estimated-life-time-savings-from-specialist-rehabilitation-following-hypoxic-brain-injury-a-large-multi-centre-cohort-analysis-from-the-uk-rehabilitation-outcomes-collaborative-ukroc-database/