Cognitive status at discharge from the hospital determines discharge destination in traumatic brain injury patients.
OBJECTIVE
To determine which basic and functional status characteristics of patients with a moderate or severe traumatic brain injury (TBI) are associated with discharge destination.


METHODS
Cross-sectional study among TBI patients. The study included 111 patients aged 16-67 years with a moderate-to-severe TBI (Glasgow Coma Scale (GCS) score 3-14). Functional outcome was assessed with Barthel Index (BI), Functional Independence Measurement (FIM), Level of Cognitive Functioning Scale (LCFS), Functional Assessment Measurement (FAM), Supervision Rating Scale (SRS) and Neurobehavioural Rating Scale (NRS). Patients were interviewed at the time of being discharged from hospital. Outcome variable was discharge destination; (1) home vs. institution and (2) rehabilitation centre vs. nursing home.


RESULTS
Gender, age and length of stay were not associated with discharge destination. TBI severity, physical status, level of arousal and cognitive status were univariately associated. Multivariate analyses, however, showed that the risk of being admitted to an institution was significantly higher for those with severe TBI (adjusted OR = 14) and/or lowered cognitive status at the time of discharge from hospital (adjusted OR = 12).


CONCLUSIONS
Discharge destination is associated with TBI-severity at admittance to the hospital and cognitive status at discharge from the hospital.
van Baalen
B
B
Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands. j.t.m.vanbaalen@erasmusmc.nl
Odding
E
E
Stam
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation; D004185:Disability Evaluation; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D016896:Treatment Outcome