Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury

Flora Hammond, Susan D. Horn, Randall J. Smout, Ronald T. Seel, Cynthia L. Beaulieu, John D. Corrigan, Ryan S. Barrett, Nora Cullen, Teri Sommerfeld, Murray E. Brandstater

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVE: To assess the frequency of, causes for, and factors associated with acute rehospitalization during 9 months after discharge from inpatient rehabilitation for traumatic brain injury (TBI).

DESIGN: Multicenter observational cohort.

SETTING: Community.

PARTICIPANTS: Individuals with TBI (N=1850) admitted for inpatient rehabilitation.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Occurrences of proxy or self-report of postrehabilitation acute care rehospitalization, as well as length of and causes for rehospitalizations.

RESULTS: A total of 510 participants (28%) had experienced 775 acute rehospitalizations. All experienced 1 admission (510 participants [66%]), whereas 154 (20%) had 2 admissions, 60 (8%) had 3, 23 (3%) had 4, 27 had between 5 and 11, and 1 had 12. The most common rehospitalization causes were infection (15%), neurological (13%), neurosurgical (11%), injury (7%), psychiatric (7%), and orthopedic (7%). The mean time from rehabilitation discharge to first rehospitalization was 113 days. The mean rehospitalization duration was 6.5 days. Logistic regression analyses revealed that older age, history of seizures before injury or during acute care or rehabilitation, history of brain injuries, and non-brain injury medical severity increased the risk of rehospitalization. Injury etiology of motor vehicle collision and high motor functioning at discharge decreased rehospitalization risk.

CONCLUSIONS: Approximately 28% of patients with TBI were rehospitalized within 9 months of TBI rehabilitation discharge owing to various medical and surgical reasons. Future research should evaluate whether some of these occurrences may be preventable (such as infections, injuries, and psychiatric disorders) and should evaluate the extent to which persons at risk may benefit from additional screening, surveillance, and treatment protocols.

Original languageEnglish (US)
Pages (from-to)S330-S39.
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number8
DOIs
StatePublished - Aug 1 2015

Fingerprint

Inpatients
Rehabilitation
Wounds and Injuries
Psychiatry
Proxy
Motor Vehicles
Clinical Protocols
Infection
Brain Injuries
Self Report
Orthopedics
Seizures
Logistic Models
Regression Analysis
Traumatic Brain Injury

Keywords

  • Brain injuries
  • Comorbidity
  • Hospitalization
  • Patient readmission
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Hammond, F., Horn, S. D., Smout, R. J., Seel, R. T., Beaulieu, C. L., Corrigan, J. D., ... Brandstater, M. E. (2015). Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 96(8), S330-S39.. https://doi.org/10.1016/j.apmr.2014.09.041

Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury. / Hammond, Flora; Horn, Susan D.; Smout, Randall J.; Seel, Ronald T.; Beaulieu, Cynthia L.; Corrigan, John D.; Barrett, Ryan S.; Cullen, Nora; Sommerfeld, Teri; Brandstater, Murray E.

In: Archives of Physical Medicine and Rehabilitation, Vol. 96, No. 8, 01.08.2015, p. S330-S39.

Research output: Contribution to journalArticle

Hammond, F, Horn, SD, Smout, RJ, Seel, RT, Beaulieu, CL, Corrigan, JD, Barrett, RS, Cullen, N, Sommerfeld, T & Brandstater, ME 2015, 'Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury', Archives of Physical Medicine and Rehabilitation, vol. 96, no. 8, pp. S330-S39.. https://doi.org/10.1016/j.apmr.2014.09.041
Hammond, Flora ; Horn, Susan D. ; Smout, Randall J. ; Seel, Ronald T. ; Beaulieu, Cynthia L. ; Corrigan, John D. ; Barrett, Ryan S. ; Cullen, Nora ; Sommerfeld, Teri ; Brandstater, Murray E. / Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury. In: Archives of Physical Medicine and Rehabilitation. 2015 ; Vol. 96, No. 8. pp. S330-S39.
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abstract = "OBJECTIVE: To assess the frequency of, causes for, and factors associated with acute rehospitalization during 9 months after discharge from inpatient rehabilitation for traumatic brain injury (TBI).DESIGN: Multicenter observational cohort.SETTING: Community.PARTICIPANTS: Individuals with TBI (N=1850) admitted for inpatient rehabilitation.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Occurrences of proxy or self-report of postrehabilitation acute care rehospitalization, as well as length of and causes for rehospitalizations.RESULTS: A total of 510 participants (28{\%}) had experienced 775 acute rehospitalizations. All experienced 1 admission (510 participants [66{\%}]), whereas 154 (20{\%}) had 2 admissions, 60 (8{\%}) had 3, 23 (3{\%}) had 4, 27 had between 5 and 11, and 1 had 12. The most common rehospitalization causes were infection (15{\%}), neurological (13{\%}), neurosurgical (11{\%}), injury (7{\%}), psychiatric (7{\%}), and orthopedic (7{\%}). The mean time from rehabilitation discharge to first rehospitalization was 113 days. The mean rehospitalization duration was 6.5 days. Logistic regression analyses revealed that older age, history of seizures before injury or during acute care or rehabilitation, history of brain injuries, and non-brain injury medical severity increased the risk of rehospitalization. Injury etiology of motor vehicle collision and high motor functioning at discharge decreased rehospitalization risk.CONCLUSIONS: Approximately 28{\%} of patients with TBI were rehospitalized within 9 months of TBI rehabilitation discharge owing to various medical and surgical reasons. Future research should evaluate whether some of these occurrences may be preventable (such as infections, injuries, and psychiatric disorders) and should evaluate the extent to which persons at risk may benefit from additional screening, surveillance, and treatment protocols.",
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AU - Hammond, Flora

AU - Horn, Susan D.

AU - Smout, Randall J.

AU - Seel, Ronald T.

AU - Beaulieu, Cynthia L.

AU - Corrigan, John D.

AU - Barrett, Ryan S.

AU - Cullen, Nora

AU - Sommerfeld, Teri

AU - Brandstater, Murray E.

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N2 - OBJECTIVE: To assess the frequency of, causes for, and factors associated with acute rehospitalization during 9 months after discharge from inpatient rehabilitation for traumatic brain injury (TBI).DESIGN: Multicenter observational cohort.SETTING: Community.PARTICIPANTS: Individuals with TBI (N=1850) admitted for inpatient rehabilitation.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Occurrences of proxy or self-report of postrehabilitation acute care rehospitalization, as well as length of and causes for rehospitalizations.RESULTS: A total of 510 participants (28%) had experienced 775 acute rehospitalizations. All experienced 1 admission (510 participants [66%]), whereas 154 (20%) had 2 admissions, 60 (8%) had 3, 23 (3%) had 4, 27 had between 5 and 11, and 1 had 12. The most common rehospitalization causes were infection (15%), neurological (13%), neurosurgical (11%), injury (7%), psychiatric (7%), and orthopedic (7%). The mean time from rehabilitation discharge to first rehospitalization was 113 days. The mean rehospitalization duration was 6.5 days. Logistic regression analyses revealed that older age, history of seizures before injury or during acute care or rehabilitation, history of brain injuries, and non-brain injury medical severity increased the risk of rehospitalization. Injury etiology of motor vehicle collision and high motor functioning at discharge decreased rehospitalization risk.CONCLUSIONS: Approximately 28% of patients with TBI were rehospitalized within 9 months of TBI rehabilitation discharge owing to various medical and surgical reasons. Future research should evaluate whether some of these occurrences may be preventable (such as infections, injuries, and psychiatric disorders) and should evaluate the extent to which persons at risk may benefit from additional screening, surveillance, and treatment protocols.

AB - OBJECTIVE: To assess the frequency of, causes for, and factors associated with acute rehospitalization during 9 months after discharge from inpatient rehabilitation for traumatic brain injury (TBI).DESIGN: Multicenter observational cohort.SETTING: Community.PARTICIPANTS: Individuals with TBI (N=1850) admitted for inpatient rehabilitation.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Occurrences of proxy or self-report of postrehabilitation acute care rehospitalization, as well as length of and causes for rehospitalizations.RESULTS: A total of 510 participants (28%) had experienced 775 acute rehospitalizations. All experienced 1 admission (510 participants [66%]), whereas 154 (20%) had 2 admissions, 60 (8%) had 3, 23 (3%) had 4, 27 had between 5 and 11, and 1 had 12. The most common rehospitalization causes were infection (15%), neurological (13%), neurosurgical (11%), injury (7%), psychiatric (7%), and orthopedic (7%). The mean time from rehabilitation discharge to first rehospitalization was 113 days. The mean rehospitalization duration was 6.5 days. Logistic regression analyses revealed that older age, history of seizures before injury or during acute care or rehabilitation, history of brain injuries, and non-brain injury medical severity increased the risk of rehospitalization. Injury etiology of motor vehicle collision and high motor functioning at discharge decreased rehospitalization risk.CONCLUSIONS: Approximately 28% of patients with TBI were rehospitalized within 9 months of TBI rehabilitation discharge owing to various medical and surgical reasons. Future research should evaluate whether some of these occurrences may be preventable (such as infections, injuries, and psychiatric disorders) and should evaluate the extent to which persons at risk may benefit from additional screening, surveillance, and treatment protocols.

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KW - Comorbidity

KW - Hospitalization

KW - Patient readmission

KW - Rehabilitation

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