Readmission to an acute care hospital during inpatient rehabilitation for traumatic brain injury
Model System:
TBIReference Type:
JournalAccession No.:
J72092Journal:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
, 96, 8, Supplement 3, S293-S303Publication Website:
Abstract:
Study assessed the incidence of, causes for, and factors associated with readmission to an acute care hospital (RTAC) during inpatient rehabilitation for traumatic brain injury (TBI). Data on RTAC incidence, RTAC causes, rehabilitation length of stay (RLOS), and rehabilitation discharge location were analyzed for 2,130 individuals with TBI admitted to 10 acute inpatient rehabilitation centers as part of a comparative effectiveness study. A total of 183 participants (9 percent) experienced RTAC for a total of 210 episodes. Of 183 participants, 161 patients experienced 1 RTAC episode, 17 had 2, and 5 had 3. The mean time from rehabilitation admission to first RTAC was 2,222 days. The mean duration in acute care during RTAC was 78 days. Eighty-four participants (46 percent) had 1 RTAC episodes for medical reasons, 102 (56 percent) had 1 RTAC episodes for surgical reasons, and 6 (3 percent) participants had RTAC episodes for unknown reasons. The most common surgical RTAC reasons were neurosurgical, pulmonary, infection, and orthopedic; the most common medical reasons were infection, neurological, and cardiac. Any RTAC was predicted as more likely for patients with older age, history of coronary artery disease, history of congestive heart failure, acute care diagnosis of depression, craniotomy or craniectomy during acute care, and presence of dysphagia at rehabilitation admission. RTAC was less likely for patients with higher admission Functional Independence Measure motor scores and education less than high school diploma. RTAC occurrence during rehabilitation was significantly associated with longer RLOS and smaller likelihood of discharge home.
Author(s):
Hammond, Flora M., Horn, Susan D., Smout, Randall J., Beaulieu, Cynthia L., Barrett, Ryan S., Ryser, David K., Sommerfeld, Teri