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Distal and Proximal Predictors of Rehospitalization Over 10 Years Among Survivors of TBI: A National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems Study
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2023
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Source: J Head Trauma Rehabil. 38(3):203-213
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Details:
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Alternative Title:J Head Trauma Rehabil
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Personal Author:
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Description:Objective:
To describe the rates and causes of rehospitalization over a 10-year period following a moderate-severe traumatic brain injury (TBI) utilizing the Healthcare Cost and Utilization Project (HCUP) diagnostic coding scheme.
Setting:
TBI Model Systems centers.
Participants:
Individuals 16 years and older with a primary diagnosis of TBI.
Design:
Prospective Cohort Study.
Main Measures:
Rehospitalization (and reason for rehospitalization) as reported by participants or their proxies during follow-up telephone interviews at 1-, 2-, 5-, and 10-years post-injury.
Results:
The greatest number of rehospitalizations occurred in the first-year post-injury (23.4% of the sample), and the rates of rehospitalization remained stable (21.1%–20.9%) at years 2 and 5 and then decreased slightly (18.6%) at year 10 post-injury. Reasons for rehospitalization varied over time, but seizure was the most common reason at years 1, 2, and 5 post-injury. Other common reasons were related to need for procedures (e.g., craniotomy or craniectomy) or medical comorbid conditions (e.g., diseases of the heart, bacterial infections, or fractures). Multivariable logistic regression models showed that FIM motor score at time of discharge from inpatient rehabilitation was consistently associated with rehospitalization at all time points. Other factors associated with future rehospitalization over time included a prior history of rehospitalization, presence of seizures, need for craniotomy/craniectomy during acute hospitalization, as well as older age and greater physical and mental health comorbidities.
Conclusion:
Using diagnostic codes to characterize reasons for rehospitalization may facilitate identification of baseline (e.g., FIM Motor score or craniotomy/craniectomy) and proximal (e.g., seizures or prior rehospitalization) factors that are associated with rehospitalization. Information about reasons for rehospitalization can aid health care system planning. By identifying those recovering from TBI at higher risk for rehospitalization, providing closer monitoring may help to decrease the healthcare burden by preventing rehospitalization.
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Source:
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Pubmed ID:36102607
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Pubmed Central ID:PMC9985661
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