168 CABINOSE: Children with Acquired Brain Injury Neurorehabilitation Outpatient Service Evaluation - Retrospective analysis study protocol

Abstract Background Children and young people (CYP) who sustain moderate to severe acquired brain injury (ABI) due to trauma, infections and tumours often have persistent symptoms including sleep disorders, anxiety, emotion dysregulation, fatigue, cognitive difficulties and poor academic performance. The relationship between post-ABI symptoms and education remains poorly understood. This study will examine the interrelationships among self-reported post-ABI problems and their impact on academic performance. Our research questions are: • How are different self-reported clinical problems related to each other? • Do these problems vary depending on the child’s age or the cause of ABI? • Which post-ABI symptoms are significantly related to academic difficulties? Method This study will be a retrospective analysis of previously collected routine care data for a multi-centre service evaluation project. This unique dataset, comprising eight paediatric neurosciences centres in England, describes demographic and clinical history, clinical variables, and school/education data from 4–18-year-old CYP with ABI who attended an outpatient follow-up clinic. Data analysis: To examine the interrelations among clinical problems, we will conduct correlation analyses and data visualisation, followed by exploratory factor analysis to identify underlying symptom dimensions. To assess variations by age and ABI type, we will use chi‑square tests for categorical variables and logistic regression models to estimate the likelihood of presenting with clinical problems, adjusting for potential confounding factors. Finally, to identify predictors of academic difficulties, we will use binary logistic regression to model the presence of academic problems and multinomial logistic regression to examine school return status. Conclusion This study will contribute to our understanding of the complex interactions of post-ABI comorbidities and their relationship with academic difficulties. These findings will support clinicians in developing targeted interventions to improve outcomes for CYP with ABI.