Citation

Erler KS, Juengst SB, Whiteneck GG, Locascio JJ, Bogner JA, Kaminski J, Giacino JT. J. Head Trauma Rehabil. 2018; 33(6): E77-E84.

Affiliation

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (Drs Erler and Giacino and Ms Kaminski); Departments of Physical Medicine and Rehabilitation and Rehabilitation Counseling, University of Texas Southwestern Medical Center, Dallas (Dr Juengst); Research Department, Craig Hospital, Englewood, Colorado (Dr Whiteneck); Department of Neurology, Harvard Medical School, Boston, Massachusetts (Dr Locascio); and Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus (Dr Bogner).

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000386

PMID

29601342

Abstract

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.

Language: en