Research Reports - Effect of age and sex on hospital readmission in traumatic brain injury

Archives of Physical Medicine and Rehabilitation
Available online 4 January 2018

Chih-YingLiPhD1AmolKarmarkarPhD1DeepakAdhikariMS2KennethOttenbacherPhD1Yong-FangKuoPhD2

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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