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.
Kirk Lercher, Raj G Kumar, Flora M Hammond and 5 others
PMID 36102607WHAT IT FOUND
Rehospitalization stayed common for 10 years after moderate to severe TBI, with 23.4% at year 1 and 18.6% at year 10.
Seizures were top reason early, fractures top at year 10. Lower motor independence and seizures were linked to higher risk.
Key findings
01Rehospitalization was reported in 23.4% of the sample at 1 year and 18.6% at 10 years; epilepsy and convulsions were the top reason at 1, 2, and 5 years, while fractures were the top reason at 10 years.
02At 1 year, lower FIM Motor at rehabilitation discharge (OR=0.98), craniotomy or craniectomy (OR=2.29), past-year seizures (OR=5.10), and more medical comorbidities (OR=2.89) were associated with rehospitalization.
03At 10 years, no baseline variables were associated, but prior rehospitalization (OR=3.25), age 65 years or older (OR=4.34), past-year seizures (OR=3.64), and more medical comorbidities (OR=2.10) were associated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only people treated at specialized TBI inpatient rehabilitation units were included, so results may not apply to all people recovering from TBI. Rehospitalization was self- or proxy-reported, so it could be underreported or overreported. People with more medical problems and hospitalizations may have been more likely to complete follow-up, which can bias the sample. The study did not know whether rehospitalizations were planned or unplanned. Reasons for rehospitalization were coded by trained staff, but miscategorization was possible. The new rehospitalization variable limited subgroup analysis by payor source and race or ethnicity.
Declared interests
The data came from the TBIMS National Database, with sites funded by the National Institute on Disability, Independent Living, and Rehabilitation Research within the Agency on Community Living in Health and Human Services.
The easy way to misread this
Do not read these associations as proof that treating seizures, improving motor independence, or adding physical therapy prevents rehospitalization. This was an observational database study, it did not test interventions, and it could not tell whether admissions were planned or unplanned.