Predicting institutionalization after traumatic brain injury inpatient rehabilitation

Short Title:
Predicting institutionalization after traumatic brain injury inpatient rehabilitation
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Reference Type:
Journal Article
Accession No.:
Year, Volume, Issue, Page(s):
2014, vol. 1, issue 32, pp 280-286
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This secondary analysis of a prospective, multi-center traumatic brain injury (TBI) registry examined the risk of institutionalization for individuals who sustained moderate and severe TBI and received inpatient rehabilitation. The study population included 7,219 patients with moderate-severe TBI in the Traumatic Brain Injury Model Systems National Database enrolled from 2002 to 2012. It was hypothesized that among people who had lived at a private residence prior to injury, greater dependence in locomotion, bed-chair-wheelchair transfers, bladder and bowel continence, feeding, and comprehension at admission to inpatient rehabilitation programs would predict institutionalization at discharge. Logistic regression was applied, with adjustment for demographic factors, proxy measures for TBI severity, and acute-care length-of-stay; the c-statistic and predictiveness curves validated a ?ve-variable model. Higher levels of independence in bladder management, bed-chair-wheelchair transfers, and comprehension at admission were associated with lower risks of institutionalization on discharge. For every 10-year increment, age was associated with a 1.38 times higher risk for institutionalization and living alone was associated with a 2.34 times higher risk. The c-statistic was 0.780. The results suggest that this simple model can predict risk of institutionalization after inpatient rehabilitation for patients with TBI.
Doiron M, Citorik A, Hunsaker E, Beninato M, Giacino J
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