Article

OBJECTIVE: To assess the incidence of, causes for, and factors associated with
readmission to an acute care hospital (RTAC) during inpatient rehabilitation for
traumatic brain injury (TBI). DESIGN: Prospective observational cohort. SETTING:
Inpatient rehabilitation. PARTICIPANTS: Individuals with TBI admitted
consecutively for inpatient rehabilitation (N=2130). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: RTAC incidence, RTAC causes, rehabilitation
length of stay (RLOS), and rehabilitation discharge location. RESULTS: A total of
183 participants (9%) experienced RTAC for a total of 210 episodes. Of 183
participants, 161 patients experienced 1 RTAC episode,
17 had 2, and 5 had 3. The
mean time from rehabilitation admission to first RTAC was 22+/-22 days. The mean
duration in acute care during RTAC was 7+/-8 days. Eighty-four participants (46%)
had >/=1 RTAC episodes for medical reasons, 102 (56%) had >/=1 RTAC episodes for
surgical reasons, and 6 (3%) participants had RTAC episodes for unknown reasons.
Most common surgical RTAC reasons were neurosurgical (65%), pulmonary (9%),
infection (5%), and orthopedic (5%); most common medical reasons were infection
(26%), neurological (23%), and cardiac (12%). Any RTAC was predicted as more
likely for patients with older age, history of coronary artery disease, history
of congestive heart failure, acute care diagnosis of depression, craniotomy or
craniectomy during acute care, and presence of dysphagia at rehabilitation
admission. RTAC was less likely for patients with higher admission FIM motor
scores and education less than high school diploma. RTAC occurrence during
rehabilitation was significantly associated with longer RLOS and smaller
likelihood of discharge home. CONCLUSIONS: Approximately 9% of patients with TBI
experienced RTAC episodes during inpatient rehabilitation for various medical and
surgical reasons. This information may help inform interventions aimed at
reducing interruptions in rehabilitation for RTAC. RTACs were associated with
longer RLOS and discharge to an institutional setting.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS