Successful Community Discharge Among Older Adults With Traumatic Brain Injury Admitted to Inpatient Rehabilitation Facilities

Evans, Emily; Gutman, Roee; Resnik, Linda; Krebill, Cicely; Lueckel, Stephanie N.; Zonfrillo, Mark R.; Thomas, Kali S.

doi:10.1016/j.arrct.2022.100241

Cited by 2 publications

(2 citation statements)

References 73 publications

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“…The models estimated the association of prior TBI and other covariates with the subdistribution of a particular type of failure in a competing risk setting, with different adjusted HRs (aHR), 95% CIs, and p values for the two competing events. To reduce confounding by prolonged pathways to hospital disposition that may be unrelated to the acute TBI, 31 35 we performed a sensitivity analysis censoring subjects with unfavorable discharge (long-term acute care, nursing facility, nursing home, hospice, or transfer to another hospital), to focus on subjects with in-hospital mortality or discharge to favorable outcome (home or rehabilitation facility). This sensitivity analysis applied the competing risk model to a three-level response variable (0=censor, 1=discharged alive, 2=in-hospital mortality).…”

Section: Methodsmentioning

confidence: 99%

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study

Yue,

Etemad,

Elguindy

et al. 2024

Trauma Surg Acute Care Open

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Objectives An estimated 14–23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort. Methods Data from hospitalized subjects with Glasgow Coma Scale score of 3–12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014–2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1–3 (vs. 4–8)) at 3, 6, and 12 months after injury. Results Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01–4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months. Conclusions After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed. Level of evidence IV. Trial registration number NCT02119182 .

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Section: Methodsmentioning

confidence: 99%

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study

Yue,

Etemad,

Elguindy

et al. 2024

Trauma Surg Acute Care Open

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“…Discharge home after acute inpatient care following TBI is traditionally viewed as a positive outcome relative to placement in long-term care facilities (Chen et al, 2014; Evans et al, 2022; Nalder et al, 2012; Turner et al, 2008). However, individuals with TBI who are discharged home but experience homeboundness may constitute an overlooked subgroup within the community.…”

mentioning

confidence: 99%

Longitudinal associations of time-varying homeboundness and life satisfaction after traumatic brain injury.

de Souza,

Ornstein,

Evans

et al. 2024

Rehabilitation Psychology

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Successful Community Discharge Among Older Adults With Traumatic Brain Injury Admitted to Inpatient Rehabilitation Facilities

Cited by 2 publications

References 73 publications

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study

Longitudinal associations of time-varying homeboundness and life satisfaction after traumatic brain injury.

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