Rehospitalization Over 10 Years Among Survivors of TBI: A National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems Study

Abstract

Objective To describe the rates and causes for rehospitalization over 10 years following moderate-severe traumatic brain injury (TBI), and to characterize longitudinal trajectories of the probability of rehospitalization using Generalized Linear Mixed Models (GLMM) and Individual Growth Curve (IGC) models conditioned on factors that help explain individual variability in rehospitalization risk over time. Design Secondary analysis of data from a multicenter longitudinal cohort study. Setting Acute inpatient rehabilitation facilities and community follow-up. Participants Individuals aged 16 years and older with a primary diagnosis of TBI. Main Outcome Measures Rehospitalization (and reason for rehospitalization) as reported by participants or proxy during follow-up telephone interviews at 1, 2, 5, and 10 years post-injury. Results The greatest number of rehospitalizations occurred in the first year post-injury (27.8% of the sample), and the rates of rehospitalization remained largely stable (22.1–23.4%) at 2, 5 and 10 years. Reasons for rehospitalization varied over time: Orthopedic and reconstructive surgery rehospitalizations were most common in Year 1, while General Health Maintenance was most common by Year 2 with rates increasing at each follow-up. Longitudinal models indicate multiple demographic and injury-related factors are associated with the probability of rehospitalization over time. Conclusion These findings can inform the content and timing of interventions to improve health and longevity after TBI.

Evaluation of a 12-month lifestyle intervention by individuals with traumatic brain injury.

“…Additionally, one caregiver reported having an unplanned hospital stay following a spontaneous bowel obstruction. This high rate of comorbid illness is not surprising as these rates are often higher among individuals with TBI (Corrigan et al, 2014; Corrigan & Hammond, 2013; Dams-O’Connor et al, 2017), although markedly the group still maintained high adherence despite these stressful life events. Future versions of the DPP-GLB TBI should incorporate an additional session focused on the unique challenges experienced by people with TBI and how their injury may impact implementing lifestyle changes.…”

The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury

“…We found weak evidence that re-hospitalization was associated with poorer independent living skills. This finding could raise the importance of early access to health services that target independent living skills [ 53 ]. Re-hospitalisations come at a significant cost to the healthcare system [ 54 ].…”

Comparative effectiveness of family problem-solving therapy (F-PST) for adolescents after traumatic brain injury: Protocol for a randomized, multicenter, clinical trial

“…Reliability has been demonstrated by both inter-rater and test/re-test reliability [ 61 , 62 ]. Predictive validity has been documented by associations between indices of lifetime history and measures of cognitive performance, affective status, interpersonal functioning and aggression [ [61] , [62] , [63] , [64] , [65] ].…”