Predictors of extended rehabilitation length of stay after traumatic brain injury

Juan Carlos Arango-Lasprilla, Jessica M. Ketchum, David Cifu, Flora Hammond, Camilo Castillo, Elizabeth Nicholls, Thomas Watanabe, Anthony Lequerica, Xiaoyan Deng

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective To develop a prediction rule for acutely identifying patients at risk for extended rehabilitation length of stay (LOS) after traumatic brain injury (TBI) by using demographic and injury characteristics. Design Retrospective cohort study. Setting Traumatic Brain Injury Model Systems. Participants Sample of TBI survivors (N=7284) with injuries occurring between 1999 and 2009. Interventions Not applicable. Main Outcome Measures Extended rehabilitation LOS defined as 67 days or longer. Results A multivariable model was built containing FIM motor and cognitive scores at admission, preinjury level of education, cause of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor source. The model had good calibration, excellent discrimination (area under the receiver operating characteristic curve = .875), and validated well. Based on this model, a formula for determining the probability of extended rehabilitation LOS and a prediction rule that classifies patients with predicted probabilities greater than 4.9% as at risk for extended rehabilitation LOS were developed. Conclusions The current predictor model for TBI survivors who require extended inpatient rehabilitation may allow for enhanced rehabilitation team planning, improved patient and family education, and better use of health care resources. Cross-validation of this model with other TBI populations is recommended.

Original languageEnglish
Pages (from-to)1495-1504
Number of pages10
JournalArchives of Physical Medicine and Rehabilitation
Volume91
Issue number10
DOIs
StatePublished - 2010

Fingerprint

Length of Stay
Rehabilitation
Survivors
Wounds and Injuries
Health Resources
Patient Education
ROC Curve
Calibration
Traumatic Brain Injury
Inpatients
Cohort Studies
Retrospective Studies
Demography
Outcome Assessment (Health Care)
Hemorrhage
Delivery of Health Care
Education
Population

Keywords

  • Brain injuries
  • Length of stay
  • Prognosis
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

Arango-Lasprilla, J. C., Ketchum, J. M., Cifu, D., Hammond, F., Castillo, C., Nicholls, E., ... Deng, X. (2010). Predictors of extended rehabilitation length of stay after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 91(10), 1495-1504. https://doi.org/10.1016/j.apmr.2010.07.010

Predictors of extended rehabilitation length of stay after traumatic brain injury. / Arango-Lasprilla, Juan Carlos; Ketchum, Jessica M.; Cifu, David; Hammond, Flora; Castillo, Camilo; Nicholls, Elizabeth; Watanabe, Thomas; Lequerica, Anthony; Deng, Xiaoyan.

In: Archives of Physical Medicine and Rehabilitation, Vol. 91, No. 10, 2010, p. 1495-1504.

Research output: Contribution to journalArticle

Arango-Lasprilla, JC, Ketchum, JM, Cifu, D, Hammond, F, Castillo, C, Nicholls, E, Watanabe, T, Lequerica, A & Deng, X 2010, 'Predictors of extended rehabilitation length of stay after traumatic brain injury', Archives of Physical Medicine and Rehabilitation, vol. 91, no. 10, pp. 1495-1504. https://doi.org/10.1016/j.apmr.2010.07.010
Arango-Lasprilla, Juan Carlos ; Ketchum, Jessica M. ; Cifu, David ; Hammond, Flora ; Castillo, Camilo ; Nicholls, Elizabeth ; Watanabe, Thomas ; Lequerica, Anthony ; Deng, Xiaoyan. / Predictors of extended rehabilitation length of stay after traumatic brain injury. In: Archives of Physical Medicine and Rehabilitation. 2010 ; Vol. 91, No. 10. pp. 1495-1504.
@article{68476c0d18c2413f87f1eda98542540d,
title = "Predictors of extended rehabilitation length of stay after traumatic brain injury",
abstract = "Objective To develop a prediction rule for acutely identifying patients at risk for extended rehabilitation length of stay (LOS) after traumatic brain injury (TBI) by using demographic and injury characteristics. Design Retrospective cohort study. Setting Traumatic Brain Injury Model Systems. Participants Sample of TBI survivors (N=7284) with injuries occurring between 1999 and 2009. Interventions Not applicable. Main Outcome Measures Extended rehabilitation LOS defined as 67 days or longer. Results A multivariable model was built containing FIM motor and cognitive scores at admission, preinjury level of education, cause of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor source. The model had good calibration, excellent discrimination (area under the receiver operating characteristic curve = .875), and validated well. Based on this model, a formula for determining the probability of extended rehabilitation LOS and a prediction rule that classifies patients with predicted probabilities greater than 4.9{\%} as at risk for extended rehabilitation LOS were developed. Conclusions The current predictor model for TBI survivors who require extended inpatient rehabilitation may allow for enhanced rehabilitation team planning, improved patient and family education, and better use of health care resources. Cross-validation of this model with other TBI populations is recommended.",
keywords = "Brain injuries, Length of stay, Prognosis, Rehabilitation",
author = "Arango-Lasprilla, {Juan Carlos} and Ketchum, {Jessica M.} and David Cifu and Flora Hammond and Camilo Castillo and Elizabeth Nicholls and Thomas Watanabe and Anthony Lequerica and Xiaoyan Deng",
year = "2010",
doi = "10.1016/j.apmr.2010.07.010",
language = "English",
volume = "91",
pages = "1495--1504",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "10",

}

TY - JOUR

T1 - Predictors of extended rehabilitation length of stay after traumatic brain injury

AU - Arango-Lasprilla, Juan Carlos

AU - Ketchum, Jessica M.

AU - Cifu, David

AU - Hammond, Flora

AU - Castillo, Camilo

AU - Nicholls, Elizabeth

AU - Watanabe, Thomas

AU - Lequerica, Anthony

AU - Deng, Xiaoyan

PY - 2010

Y1 - 2010

N2 - Objective To develop a prediction rule for acutely identifying patients at risk for extended rehabilitation length of stay (LOS) after traumatic brain injury (TBI) by using demographic and injury characteristics. Design Retrospective cohort study. Setting Traumatic Brain Injury Model Systems. Participants Sample of TBI survivors (N=7284) with injuries occurring between 1999 and 2009. Interventions Not applicable. Main Outcome Measures Extended rehabilitation LOS defined as 67 days or longer. Results A multivariable model was built containing FIM motor and cognitive scores at admission, preinjury level of education, cause of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor source. The model had good calibration, excellent discrimination (area under the receiver operating characteristic curve = .875), and validated well. Based on this model, a formula for determining the probability of extended rehabilitation LOS and a prediction rule that classifies patients with predicted probabilities greater than 4.9% as at risk for extended rehabilitation LOS were developed. Conclusions The current predictor model for TBI survivors who require extended inpatient rehabilitation may allow for enhanced rehabilitation team planning, improved patient and family education, and better use of health care resources. Cross-validation of this model with other TBI populations is recommended.

AB - Objective To develop a prediction rule for acutely identifying patients at risk for extended rehabilitation length of stay (LOS) after traumatic brain injury (TBI) by using demographic and injury characteristics. Design Retrospective cohort study. Setting Traumatic Brain Injury Model Systems. Participants Sample of TBI survivors (N=7284) with injuries occurring between 1999 and 2009. Interventions Not applicable. Main Outcome Measures Extended rehabilitation LOS defined as 67 days or longer. Results A multivariable model was built containing FIM motor and cognitive scores at admission, preinjury level of education, cause of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor source. The model had good calibration, excellent discrimination (area under the receiver operating characteristic curve = .875), and validated well. Based on this model, a formula for determining the probability of extended rehabilitation LOS and a prediction rule that classifies patients with predicted probabilities greater than 4.9% as at risk for extended rehabilitation LOS were developed. Conclusions The current predictor model for TBI survivors who require extended inpatient rehabilitation may allow for enhanced rehabilitation team planning, improved patient and family education, and better use of health care resources. Cross-validation of this model with other TBI populations is recommended.

KW - Brain injuries

KW - Length of stay

KW - Prognosis

KW - Rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=77957304745&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957304745&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2010.07.010

DO - 10.1016/j.apmr.2010.07.010

M3 - Article

C2 - 20875505

AN - SCOPUS:77957304745

VL - 91

SP - 1495

EP - 1504

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 10

ER -