Research Reports - Rehospitalization during 9 months After inpatient rehabilitation for traumatic brain injury

Arch Phys Med Rehabil. 2015 Aug;96(8 Suppl):S330-S339.e4. doi:
10.1016/j.apmr.2014.09.041.

Hammond FM(1), Horn SD(2), Smout RJ(2), Seel RT(3), Beaulieu CL(4), Corrigan
JD(5), Barrett RS(2), Cullen N(6), Sommerfeld T(7), Brandstater ME(8).

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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