Predictors of inpatient (neuro)rehabilitation after acute care of severe traumatic brain injury: An epidemiological study

Schumacher, Rahel; Walder, Bernhard; Delhumeau, Cécile; Müri, René M.

doi:10.1080/02699052.2016.1183821

Cited by 34 publications

(42 citation statements)

References 25 publications

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“…Admission rates to neurorehabilitation for survivors of severe TBI differ widely between countries. Data from specialized trauma centres in Texas (U.S., 11 centres), Switzerland (12 centres), Norway (4 centres), and Denmark (4–5 centres) show rates of 45%, 44% (+16% non-specialized rehabilitation), 75% (+11% non-specialized), and 84%, respectively [76,77,78,79]. The comparability of these data is limited as a result of unequal populations (e.g., the Norwegian and Danish ones showing a notably lower mean age and a large proportion of younger patients, respectively), but these differences could also partly be explained by health system-inherent factors such as national guidelines, cost coverage/reimbursement, and centralization of institutions.…”

Section: Admission To Rehabilitation After Tbimentioning

confidence: 99%

Neurorehabilitation of Traumatic Brain Injury (TBI): A Clinical Review

Oberholzer

Müri

2019

Medical Sciences

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Traumatic brain injury (TBI) and its potential long-term consequences are of major concern for public health. Neurorehabilitation of affected individuals has some specific characteristics in contrast to neurorehabilitation of patients with acquired brain lesions of other aetiology. This review will deal with the clinical consequences of the distinct lesions of TBI. In severe TBI, clinical course often follows a typical initial sequence of coma; followed by disturbed consciousness; later, post-traumatic agitation and amnesia; and finally, recovery of function occurs. In the different phases of neurorehabilitation, physicians should be aware of typical medical complications such as paroxysmal sympathetic hyperactivity, posttraumatic hydrocephalus, and posttraumatic neuroendocrine dysfunctions. Furthermore, we address questions on timing and on existing evidence for different rehabilitation programmes and for holistic neuropsychological rehabilitation approaches.

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Section: Admission To Rehabilitation After Tbimentioning

confidence: 99%

Neurorehabilitation of Traumatic Brain Injury (TBI): A Clinical Review

Oberholzer

Müri

2019

Medical Sciences

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“…Some studies have reported sex differences in service provision, such as higher healthcare use in females (15). In other studies, males received more services (16), or sex was not related to service provision (8,9). Furthermore, some studies reported that younger individuals with TBI more often received rehabilitation (8,(15)(16)(17), while others reported that older aged individuals received more rehabilitation services (16,18,19).…”

mentioning

confidence: 99%

Long-term follow-up of use of therapy services for patients with moderate-to-severe traumatic brain injury

Anđelić¹,

Forslund²,

Perrin³

et al. 2020

J Rehabil Med

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Long-term disabilities are common after traumatic brain injury. Consequently, many patients need healthcare services following injury. This study followed 97 individuals with traumatic brain injury until 10 years after injury, and found that the use of physical therapy, occupational therapy and speech therapy decreased substantially over time. Approximately 1 in 6 individuals used physical therapy at 10 years, whereas the use of occupational and speech therapy was much lower. Higher use of services was associated with more severe injury, female sex, and being employed before injury. The low level of service use at 10 years after injury might indicate unmet needs in this patient population. Objectives: To examine the probabilities and baseline predictors of the use of physical therapy, occupational therapy and speech therapy over a period of 10 years after traumatic brain injury. Design: Longitudinal prospective follow-up at 1, 2, 5 and 10 years after traumatic brain injury. Participants: A total of 97 patients with moderateto-severe traumatic brain injury recruited from Oslo University Hospital, Norway, during acute hospital admission in 2005-2007. Methods: Socio-demographics and injury characteristics were recorded at baseline. Use of physical therapy, occupational therapy and speech therapy were recorded at follow-ups. Hierarchical linear modelling was applied to examine service use probabilities across the 4 time-points. Results: Service use decreased substantially over time, with physical therapy being the main service utilized at the 10-year follow-up (physical therapy 16%, occupational therapy 1%, speech therapy 3%). Use of services was related to severity of injury (CT head severity scores and post-traumatic amnesia), female sex, and pre-injury employment. In addition, in this sample, time since injury was associated with use of occupational therapy and speech therapy. Conclusion: This study presents a novel model for the long-term probability of use of physical therapy, occupational therapy and speech therapy following traumatic brain injury. The use of services was much lower than the expected problem profile of severe traumatic brain injuries, suggesting an insufficient long-term provision of traditional traumatic brain injury rehabilitation services.

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“…4 12 During the last decade, improving quality of care and increasing the number of survivors have gradually shifted the focus of research from discharge status (morbidity or mortality) [22][23][24] to that of discharge destination. [25][26][27] In order to use discharge destination as a measure of clinical priorities and pathway of care, it is important to understand the factors that contribute to this outcome. While some studies suggest that discharge to a rehabilitation setting is mostly related to preinjury functioning and overall severity of injury, 25 27 28 others indicate that demographic and socio-economic factors are the main elements that correlate with discharge to rehabilitation facilities versus home and other institutionalised care settings.…”

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confidence: 99%

Predictors of Discharge Destination From Acute Care in Patients With Traumatic Brain Injury: A Systematic Review

Zarshenas

Colantonio

Alavinia

et al. 2019

Journal of Head Trauma Rehabilitation

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Objective: To systematically review studies on clinical and nonclinical predictors of discharge destination from acute care in patients with traumatic brain injury. Methods: The search was conducted using 7 databases up to December 2016. A systematic review and in-depth quality synthesis were conducted on eligible articles that met the inclusion criteria. Results: The search yielded 8503 articles of which 18 studies met the inclusion criteria. This study demonstrated that a larger proportion of patients with traumatic brain injury were discharged home. The main predictors of discharge to a setting with rehabilitation services versus home included increasing age, white and non-Hispanic race/ethnicity, having insurance coverage, greater severity of the injury, and longer acute care length of stay. Age was the only consistent factor that was negatively associated with discharge to inpatient rehabilitation facilities versus other institutions. Conclusion: Results of this study support healthcare providers in providing consultation to patients about the expected next level of cares while considering barriers that may helpful in effective discharge planning, decreasing length of stay and saving resources. These findings also suggest the need for further studies with a stronger methodology on the contribution of patients and families/caregivers to distinguish the predictors of discharge to dedicated rehabilitation facilities.

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Predictors of inpatient (neuro)rehabilitation after acute care of severe traumatic brain injury: An epidemiological study

Cited by 34 publications

References 25 publications

Neurorehabilitation of Traumatic Brain Injury (TBI): A Clinical Review

Neurorehabilitation of Traumatic Brain Injury (TBI): A Clinical Review

Long-term follow-up of use of therapy services for patients with moderate-to-severe traumatic brain injury

Predictors of Discharge Destination From Acute Care in Patients With Traumatic Brain Injury: A Systematic Review

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