Cluster Analysis of Vulnerable Groups in Acute Traumatic Brain Injury Rehabilitation.
N Erkut Kucukboyaci, Coralynn Long, Michelle Smith and 2 others
PMID 29317223WHAT IT FOUND
In acute traumatic brain injury rehab, 148 patients formed four vulnerability clusters.
Clusters differed in length of stay and functional independence gains, and elderly medically complex patients were the oldest cluster.
Key findings
01Cluster analysis of 148 patients identified four stable vulnerability clusters; Clusters B and C, linked to minority and limited English membership, comprised more than half the sample.
02Length of stay and cognitive FIM score change differed significantly between clusters (p = .012 and p = .014).
03Large differences in FIM total score and FIM motor score change between Clusters A and B were observed but were not statistically significant, and discharge disposition differences were described as large but statistically insignificant under a stricter cutoff.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was a retrospective chart review of 148 patients, so it cannot show that vulnerability clusters caused different rehabilitation outcomes. The sample came from urban data in one of the most ethnically diverse metropolitan regions in the U.S., so it may not represent more homogeneous regions. Cluster micro-level results can be sensitive to the type, number, and definition of input variables. Small undocumented and other vulnerability groups were present, and the analysis was repeated with nine vulnerability groups. A length-of-stay value greater than 5 months was excluded from relevant group-wise statistics. Some large outcome differences were not statistically significant, and discharge disposition was called insignificant under a stricter cutoff.
Declared interests
No author conflict-of-interest statement appears in the supplied text. The article is tagged as supported by U.S. government, non-PHS funding.
The easy way to misread this
Do not treat these clusters as a way to predict an individual patient's stay or functional gains. The study was retrospective, used 148 patients from a diverse urban region, and some large outcome differences were not statistically significant.