Research Reports - The association of rehospitalization with participation 5 years after traumatic brain injury

The Journal of Head Trauma Rehabilitation: March 29, 2018

Erler, Kimberly, S.; Juengst, Shannon, B.; Whiteneck, Gale, G.; Locascio, Joseph, J.; Bogner, Jennifer, A.; Kaminski, Jamie; Giacino, Joseph, T.

Objective: To determine whether rehospitalization during the first 2 years after moderate to severe traumatic brain injury (TBI) is associated with poor participation at 5 years post-TBI, after controlling for demographic and severity factors.

Setting: TBI Model Systems Program.

Participants: Community-dwelling individuals with TBI, 16 years or older (n = 1940).

Design: Retrospective data analysis of a multicenter prospective study.

Main Measures: Participation Assessment with Recombined Tools-Objective (PART-O).

Results: After controlling for demographic and severity factors, a general linear model indicated that rehospitalization status (ie, never rehospitalized during years 1 and 2, rehospitalized either during year 1 or 2, or rehospitalized during both years 1 and 2) predicted less participation at 5 years post-TBI (P = .0353). The PART-O scores were in the hypothesized direction, with the lowest covariate-adjusted mean participation score found for the group with rehospitalizations during both years and the highest covariate-adjusted mean participation score found in the group with no rehospitalizations. Examining total number of rehospitalizations during years 1 and 2, rather than rehospitalization status, yielded analogous results (P = .0148).

Conclusions: This study suggests that rehospitalization in the first 2 years after TBI is negatively associated with participation at 5 years after injury. Since participation is considered a key indicator of successful TBI rehabilitation, minimizing the need for rehospitalizations and promoting health in the community setting should be a priority of postacute care for individuals with TBI.

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