Rehospitalization After Traumatic Brain Injury: A Population-Based Study

Saverino, Cristina; Swaine, Bonnie; Jaglal, Susan; Lewko, John H.; Vernich, Lee; Voth, Jennifer; Calzavara, Andrew; Colantonio, Angela

doi:10.1016/j.apmr.2015.04.016

Cited by 52 publications

(51 citation statements)

References 27 publications

(49 reference statements)

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“…Such inconsistency may be due to the variety in study timeframe and national healthcare policies between this study and ours. However, our study agreed with Saverino et al 19 that those who were male, older, had more severe injury and more comorbidities had significantly higher readmission rates over time.…”

Section: Discussionsupporting

confidence: 92%

“…Contradictorily, the Canadian population-based TBI study 19 found no sex differences in the number of rehospitalizations for the first year, even though women between 15 and 49 years old had 15% more rehospitalizations than men at the 3-year follow-up. Such inconsistency may be due to the variety in study timeframe and national healthcare policies between this study and ours.…”

Section: Discussionmentioning

confidence: 96%

“…In addition, most of the work related to hospital readmission has been conducted using a 30-day follow-up period. Only one recent Canadian population-based study examined the predictors of rehospitalization in a 3-year period post-TBI and identified the following significant predictors: male, older age, falls, greater injury severity, rural residence, greater comorbidity and psychiatric comorbidity 19 . To our knowledge, this study is the first to analyze the U.S. nationally representative TBI data for adults at all ages, covering all insurance plans across a 90-day follow-up period.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Age and Sex on Hospital Readmission in Traumatic Brain Injury

Karmarkar

Adhikari

et al. 2018

Archives of Physical Medicine and Rehabilitation

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Objective To investigate the impact of age and sex on 30-, 60- and 90-day hospital readmission after acute hospital discharge for individuals with traumatic brain injury (TBI). Design Retrospective cohort study. Setting Acute hospitals and post-acute discharge settings Participants From the 2013 Nationwide Readmissions Database, we retrieved information on 52,877 individuals with diagnosis-related group codes of TBI. We included only those alive at index acute discharge and excluded those discharged with same-day readmission. We divided our sample into four age groups: 18-40, 41-65, 66-75 and 76+ years old. Interventions NA. Main Outcome Measure(s) All-cause hospital readmission. Results Sex differences in 30-, 60- and 90-day hospital readmission were found for all age groups (all p<.05). The largest sex differences in hospital readmission were in the two oldest groups (66-75, 76+). For both sexes, the oldest group (76+) had the highest adjusted 90-day readmission risk [e.g., 90-day readmission: Odds Ratio (OR) = 2.32 (2.01-2.69) for males; OR=1.96 (1.59-2.43) for females]. Among those readmitted within 90 days, the youngest group (18-40 years) had the highest cumulative readmission percent (35% for both sexes) within the first week post-hospital discharge. Conclusion Age and sex were significantly associated with hospital readmission during the first 90 days post-discharge in our TBI sample. Specifically, those aged 66-75 or 76+ had the highest readmission risk over 90 days for both sexes. The findings suggest that clinicians should consider age and sex in discharge planning and for the entire episode of care for the TBI population.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Effects of Age and Sex on Hospital Readmission in Traumatic Brain Injury

Karmarkar

Adhikari

et al. 2018

Archives of Physical Medicine and Rehabilitation

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“…None of the studies analysed in this review compared the effect of VRT between sexes. Although it has been reported that females may be more vulnerable to concussions, studies investigating sex differences in recovery time remain limited and inconclusive 54. Further research is also required to determine the optimal time frame to begin VRT post concussion, as well as determining the prescription and progression patterns that provide the most effective recovery.…”

Section: Discussionmentioning

confidence: 99%

Can vestibular rehabilitation exercises help patients with concussion? A systematic review of efficacy, prescription and progression patterns

2016

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“…6 In general, research in this area to date has demonstrated rehospitalization to be a substantial problem that reflects a need for a more detailed understanding of the risk factors as well as proximal causes for return to the acute setting. Identifying key intervention points for the prevention of relapses is essential to permit more successful outcomes for TBI patients.…”

mentioning

confidence: 99%

Rehospitalization in the First Year Following Veteran and Service Member TBI: A VA TBI Model Systems Study

Tran¹,

Hammond

Dams-O’Connor

et al. 2017

Journal of Head Trauma Rehabilitation

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Objective Determine the incidence and causes of rehospitalization following Military or Veteran TBI. Setting VAVeterans Health Administration’sPolytrauma Rehabilitation Centers (VHA PRC). Participants Consecutive sample of VHA TBI Model System participants (N=401) Design Prospective observational cohort study. Main Measures Number and type of rehospitalizations in first year post-TBI. Results 41% of 401 participants were rehospitalized. Rehospitalization status was associated with greater injury severity and receipt of TBI while active duty. Of those rehospitalized, 30% had 2 or more readmissions. Participants experiencing multiple rehospitalizations (2+) were more likely to have sustained their TBI during deployment compared to those with none or single rehospitalization. This group also sustained more severe injuries and spent more time in VA PRC inpatient rehabilitation. Common reasons for rehospitalization included inpatient rehabilitation (33%), unspecified (26%), orthopedic (10%), seizures (8%), infection (8%), psychiatric (7%). Conclusion This is the first study examining military and Veteran rehospitalization following TBI requiring inpatient rehabilitation at a VA PRC. Findings suggest frequent rehospitalization in the first year post-injury suggesting the need for preventative models of health maintenance following inpatient rehabilitation discharge. Greater surveillance of those with deployment-related TBI or active duty at time of injury and greater TBI severity may be warranted.

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Rehospitalization After Traumatic Brain Injury: A Population-Based Study

Abstract: Rehospitalization after TBI is common. Factors associated with rehospitalization can inform long-term postdischarge planning. Findings also support examining causes for rehospitalization by age and sex.

Cited by 52 publications

References 27 publications

Effects of Age and Sex on Hospital Readmission in Traumatic Brain Injury

Effects of Age and Sex on Hospital Readmission in Traumatic Brain Injury

Can vestibular rehabilitation exercises help patients with concussion? A systematic review of efficacy, prescription and progression patterns

Rehospitalization in the First Year Following Veteran and Service Member TBI: A VA TBI Model Systems Study

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