Predictors of inpatient (neuro)rehabilitation after acute care of severe traumatic brain injury: An epidemiological study.

Objective: To describe the discharge destination of patients with severe traumatic brain injury (sTBI) after acute care. To identify predictors associated with inpatient rehabilitation (vs discharge home) and to identify predictors associated with neurorehabilitation (vs general rehabilitation). Met...

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Publicado en:Brain Injury Vol. 30; no. 10; pp. 1186 - 1194
Autores principales: Schumacher, Rahel, Walder, Bernhard, Delhumeau, Cécile, Müri, René M.
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd 2016
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/02699052.2016.1183821
        118094249
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        atl: Predictors of inpatient (neuro)rehabilitation after acute care of severe traumatic brain injury: An epidemiological study.
      aug:
        au:
          Schumacher, Rahel
          Walder, Bernhard
          Delhumeau, Cécile
          Müri, René M.
        affil: Division of Cognitive and Restorative Neurology, Department of Neurology
      sug:
        subj:
          Brain Injuries Rehabilitation
          Transfer, Discharge
          After Care
          Outcomes (Health Care)
          Multicenter Studies
          Prospective Studies
          Epidemiological Research
          Human
          Scales
          Multiple Logistic Regression
          Severity of Injury
          Referral and Consultation
          Switzerland
          Trauma Centers
          Trauma Severity Indices
          Rehabilitation Centers
          Nursing Homes
          T-Tests
          Wilcoxon Signed Rank Test
          Chi Square Test
          Fisher's Exact Test
          P-Value
          Data Analysis Software
          Descriptive Statistics
          Confidence Intervals
          Odds Ratio
          Male
          Female
          Adult
          Middle Age
          Aged
          Inpatients
          Socioeconomic Factors
          Glasgow Coma Scale
          Neuropsychological Tests
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objective: To describe the discharge destination of patients with severe traumatic brain injury (sTBI) after acute care. To identify predictors associated with inpatient rehabilitation (vs discharge home) and to identify predictors associated with neurorehabilitation (vs general rehabilitation). Methods: A national, multi-centre, prospective study with adult survivors after sTBI (abbreviated injury scale head score > 3). Univariate and multivariate logistic regression models included patient characteristics, pre-injury conditions, initial neuro-physiological assessment, trauma mechanisms, severity of TBI and pre-hospital conditions to find predictors of discharge destination. Results: Out of the 566 included patients, 341 (60%) were referred to inpatient rehabilitation, thereof 249 (73%) to neurorehabilitation; 225 (40%) were discharged home or to a nursing home. Lower scores on the Glasgow Coma Scale at admission/at 14 days, higher injury severity scores and older age were predictors for inpatient rehabilitation. Younger age and male gender were predictors for neurorehabilitation. Conclusions: Patients’ pathways after acute care are not only determined by the severity of their brain injury, but also by their overall injury severity and socio-biological factors. More than half of the patients after sTBI are not discharged to specialized inpatient neurorehabilitation and, therefore, efforts should be taken to optimize post-acute care.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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