Psychosocial Factors Associated with Prolonged Length of Stay in Acquired Brain Injury Rehabilitation: A Retrospective Cohort Study.
Alexandre McDougall, Swapna Mylabathula, Mohammad Alavinia and 4 others
PMID 37389479WHAT IT FOUND
Patients living in communal settings before admission were 14 times more likely to stay beyond their target discharge date.
Not having a driver's licence also predicted longer stays. These social factors blocked discharge logistics rather than reflecting poor rehabilitation progress.
Key findings
01Premorbid communal living (e.g., group home, assisted living) was associated with an odds ratio of 14.67 for exceeding the target length of stay.
02Patients without a driver's licence prior to their brain injury had an odds ratio of 2.63 for staying beyond their target length of stay.
03In multiple regression models, no psychosocial factors significantly predicted total length of stay; only admission FIM score and 'Other' ABI type were significant.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was conducted at a single centre, limiting generalizability to other healthcare systems with different discharge protocols. The 'Other' ABI group was heterogeneous, combining diagnoses like anoxic brain injury and metabolic encephalopathies, making it difficult to attribute findings to specific conditions. Only total FIM scores were used, missing the granularity of motor versus cognitive subscores which might have provided different insights into rehabilitation progress. Three outliers with extremely long stays were excluded from the total LOS linear regression analysis, potentially biasing the results toward more typical cases.
Declared interests
No conflicts of interest or funding sources are explicitly stated in the provided text.
The easy way to misread this
Do not assume that patients with longer stays are making poor rehabilitation progress. The study found that social factors like communal living predicted exceeding target dates due to discharge logistics, not necessarily because patients were functionally slower to recover.