Home, but Homebound After Traumatic Brain Injury: Risk Factors and Associations With Nursing Home Entry and Death.

This was an observational cohort, so it shows associations, not proof that homeboundness causes death or nursing home entry. Homebound status came from one question about leaving home, and the study did not know whether preference, physical limits, transportation, or other reasons drove it. The sample was limited to people with moderate-severe TBI who required inpatient rehabilitation and were living in a private residence at 1 year, so results may not apply to milder TBI or people discharged to institutions. People with no follow-up after year 1 or unknown death date were excluded from mortality models, and people lost to follow-up may have been more demographically vulnerable. The nursing home association was not robust after adjustment for clinical factors. Medical comorbidity was measured with a score developed to predict mortality, so it may not have captured health problems relevant to homeboundness. Homebound status was assessed only before the pandemic, so current patterns may differ.

The supplied text does not report an author conflicts-of-interest statement. The publication types list NIH and U.S. Public Health Service research support.

Do not conclude that helping patients leave home will reduce death or nursing home entry. The study found associations, not tested interventions, and the nursing home association no longer reached statistical significance after adjustment (RR=1.90, 95% CI: 0.94, 3.87, p=0.075).