Citation

Nakase-Richardson R, Tran J, Cifu D, Barnett SD, Horn LJ, Greenwald BD, Brunner RC, Whyte J, Hammond FM, Yablon SA, Giacino JT. Arch. Phys. Med. Rehabil. 2013; 94(10): 1884-1890.

Affiliation

James A. Haley Veterans Hospital; Center of Excellence for Maximizing RehabilitationOutcomes; University of South Florida, Tampa, FL. Electronic address: Risa.Richardson@va.gov.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.11.054

PMID

23770278

Abstract

OBJECTIVE: To examine the rate and nature of rehospitalizations among persons with varying levels of injury severity enrolled in the NIDRR Traumatic Brain Injury Model Systems (TBIMS) and discharged from acute inpatient rehabilitation. The rate and nature of rehospitalization in a cohort of patients with disorder of consciousness (DOC) at the time of rehabilitation admission were compared to persons with moderate or severe traumatic brain injury (TBI) but without a DOC at rehabilitation admission. DESIGN: Prospective observational study. SETTING: Inpatient rehabilitation within TBIMS with annual follow-up. PARTICIPANTS: Of 9028 persons enrolled from 1988-2009, 366 from 20 centers met criteria for DOC at rehabilitation admission and follow-up data, and another 5132 individuals met criteria for moderate (n=769) or severe TBI (n=4363). Interventions: None. Main Outcome Measures: Participants and/or their family members completed follow-up data collection including questions about frequency and nature of rehospitalizations at 1-year post-injury. For the subset of DOC participants, additional follow-up was conducted at 2 and 5 years post-injury. RESULTS: The DOC group demonstrated an overall two-fold increase in rehospitalization in the first year post-injury relative to those with moderate or severe TBI without DOC. Persons with DOC at rehabilitation admission have a higher rate of rehospitalization across several categories than persons with moderate or severe TBI. CONCLUSIONS: Although the specific details of rehospitalization are unknown, greater injury severity resulting in DOC status upon rehabilitation admission has long-term implications. Data highlight the need for a longitudinal approach to patient management.

Language: en