Influence of sex and age on inpatient rehabilitation outcomes among older adults with traumatic brain injury.
Graham JE, Radice-Neumann DM, Reistetter TA, Hammond FM, Dijkers M, Granger CV. Influence of sex and age on inpatient rehabilitation outcomes among older adults with traumatic brain injury.


OBJECTIVE
To assess the influence of sex and age on inpatient rehabilitation outcomes in a large national sample of older adults with traumatic brain injury (TBI).


METHODS
Prospective case series.


METHODS
Eight hundred forty-eight inpatient rehabilitation facilities that subscribe to the Uniform Data System for Medical Rehabilitation.


METHODS
Patients (n=18,413) age 65 years and older admitted for inpatient rehabilitation after TBI from 2005 through 2007.


METHODS
None.


METHODS
Rehabilitation length of stay, discharge FIM motor and cognitive ratings, discharge setting, and scheduled home health services at discharge.


RESULTS
Mean age +/- SD of the sample was 79+/-7 years, and 47% were women. In multivariable models, higher age was associated with shorter lengths of stay (P<.001), lower discharge FIM motor and cognitive ratings (P<.001), and greater odds of home health services at discharge (P<.001). Women demonstrated shorter lengths of stay (P=.006) and greater odds of being scheduled for home health services at discharge (P<.001) than men. The sex-by-age interaction term was not significant in any outcome model. Sex differences and trends were consistent across the entire age range of the sample.


CONCLUSIONS
Sex and age patterns in rehabilitation outcomes among older adults with TBI varied by outcome. The current findings related to rehabilitation length of stay may be helpful for facility-level resource planning. Additional studies are warranted to identify the factors associated with returning to home and to assess the long-term benefits of combined inpatient rehabilitation and home health services for older adults with TBI.
Graham
James E
JE
Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA. jegraham@utmb.edu
Radice-Neumann
Dawn M
DM
Reistetter
Timothy A
TA
Hammond
Flora M
FM
Dijkers
Marcel
M
Granger
Carl V
CV
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000534:rehabilitation*; D003071:Cognition; D015897:Comorbidity; D005260:Female; D006699:Home Care Services; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009048:Motor Skills; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012737:Sex Factors; D016896:Treatment Outcome