title: Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury.
abstract: OBJECTIVE
  To assess the frequency of, causes for, and factors associated with acute rehospitalization during 9 months after discharge from inpatient rehabilitation for traumatic brain injury (TBI).
  
  
  METHODS
  Multicenter observational cohort.
  
  
  METHODS
  Community.
  
  
  METHODS
  Individuals with TBI (N=1850) admitted for inpatient rehabilitation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Occurrences of proxy or self-report of postrehabilitation acute care rehospitalization, as well as length of and causes for rehospitalizations.
  
  
  RESULTS
  A total of 510 participants (28%) had experienced 775 acute rehospitalizations. All experienced 1 admission (510 participants [66%]), whereas 154 (20%) had 2 admissions, 60 (8%) had 3, 23 (3%) had 4, 27 had between 5 and 11, and 1 had 12. The most common rehospitalization causes were infection (15%), neurological (13%), neurosurgical (11%), injury (7%), psychiatric (7%), and orthopedic (7%). The mean time from rehabilitation discharge to first rehospitalization was 113 days. The mean rehospitalization duration was 6.5 days. Logistic regression analyses revealed that older age, history of seizures before injury or during acute care or rehabilitation, history of brain injuries, and non-brain injury medical severity increased the risk of rehospitalization. Injury etiology of motor vehicle collision and high motor functioning at discharge decreased rehospitalization risk.
  
  
  CONCLUSIONS
  Approximately 28% of patients with TBI were rehospitalized within 9 months of TBI rehabilitation discharge owing to various medical and surgical reasons. Future research should evaluate whether some of these occurrences may be preventable (such as infections, injuries, and psychiatric disorders) and should evaluate the extent to which persons at risk may benefit from additional screening, surveillance, and treatment protocols.
authors.affiliation: Carolinas Rehabilitation, Charlotte, NC; Indiana University School of Medicine, Indianapolis, IN. Electronic address: flora.hammond@rhin.com.
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT.
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
authors.affiliation: Crawford Research Institute, Shepherd Center, Atlanta, GA.
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Seel
authors.affiliation: Brooks Rehabilitation Hospital, Jacksonville, FL.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Beaulieu
authors.affiliation: Ohio State University, Columbus, OH.
authors.forename: John D
authors.initials: JD
authors.lastname: Corrigan
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Barrett
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Nora
authors.initials: N
authors.lastname: Cullen
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Teri
authors.initials: T
authors.lastname: Sommerfeld
authors.affiliation: Loma Linda University Medical Center, Loma Linda, CA.
authors.forename: Murray E
authors.initials: ME
authors.lastname: Brandstater
mesh_terms: D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology
keywords: Brain injuries; Comorbidity; Hospitalization; Patient readmission; Rehabilitation