Multicentre cohort identifies a distinct vulnerability subgroup after home return from severe brain injury

A multicentre retrospective cohort study in the Journal of Rehabilitation Medicine followed 2,835 adults after home return from severe traumatic brain injury and identified a distinct “multidomain vulnerability” subgroup — 17% of the cohort — at one year, characterised by depression, anxiety, low life satisfaction and elevated five-year rehospitalisation risk [Primary Study]. Female sex, pre-injury illicit drug use and living alone at one year predicted membership of this subgroup.

The study reframes home return from severe traumatic brain injury as a transition point requiring longitudinal psychosocial surveillance, rather than a point at which formal follow-up ends. This is a single retrospective cohort analysis, and the authors do not report external validation of the risk profile in an independent sample.

For community neuro-rehabilitation and psychology services, this argues for risk-profiling patients at the point of discharge — flagging those living alone, with a history of substance use, or of female sex — for enhanced follow-up ahead of the one-year mark, rather than assuming stability once inpatient rehabilitation ends.