@article{ref1,
title="Successful community discharge among older adults with traumatic brain injury admitted to inpatient rehabilitation facilities",
journal="Archives of rehabilitation research and clinical translation",
year="2022",
author="Evans, Emily and Gutman, Roee and Resnik, Linda and Krebill, Cicely and Lueckel, Stephanie N. and Zonfrillo, Mark R. and Thomas, Kali S.",
volume="4",
number="4",
pages="e100241-e100241",
abstract="OBJECTIVE: To identify admission characteristics that predict a successful community discharge from an inpatient rehabilitation facility (IRF) among older adults with traumatic brain injury (TBI). <br><br>DESIGN: In a retrospective cohort study, we leveraged probabilistically linked Medicare Administrative, IRF-Patient Assessment Instrument, and National Trauma Data Bank data to build a parsimonious logistic model to identify characteristics associated with successful discharge. Multiple imputation methods were used to estimate effects across linked datasets to account for potential data linkage errors. SETTING: Inpatient Rehabilitation Facilities in the U.S. PARTICIPANTS: The sample included a mean of 1060 community-dwelling adults aged 66 years and older across 30 linked datasets (N=1060). All were hospitalized after TBI between 2011 and 2015 and then admitted to an IRF. The mean age of the sample was 79.7 years, and 44.3% of the sample was women. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Successful discharge home. <br><br>RESULTS: Overall, 64.6% of the sample was successfully discharged home. A logistic model including 4 predictor variables: Functional Independence Measure motor (FIM-M) and cognitive (FIM-C) scores, pre-injury chronic conditions, and pre-injury living arrangement, that were significantly associated with successful discharge, resulted in acceptable discrimination (area under the curve: 0.76, 95% confidence interval [CI]: 0.72-0.81). Higher scores on the FIM-M (odds ratio [OR]:1.07, 95% CI: 1.05-1.09) and FIM-C (OR: 1.05, 95% CI: 1.02-1.08) were associated with greater odds of successful discharge, whereas living alone vs with others (OR: 0.46, 95% CI: 0.30-0.71) and a greater number of chronic conditions (OR: 0.94, 95% CI: 0.90-0.99) were associated with lower odds of successful discharge. <br><br>CONCLUSIONS: The results provide a parsimonious model for predicting successful discharge among older adults admitted to an IRF after a TBI-related hospitalization and provide clinically useful information to inform discharge planning.<p /> <p>Language: en</p>",
language="en",
issn="2590-1095",
doi="10.1016/j.arrct.2022.100241",
url="http://dx.doi.org/10.1016/j.arrct.2022.100241"
}