Article

OBJECTIVE: To investigate demographic and acute care clinical determinants of
admission to inpatient rehabilitation (IR) among patients with hypoxic-ischemic
brain injury (HIBI) who survive the initial acute care episode. DESIGN: Population-wide prospective cohort study using Canadian Institutes for Health
Information administrative health data from Ontario, Canada. All patients who
survived their HIBI acute care episode during the study period remained eligible
for the outcome, admission to IR, for 1 year postacute care discharge. SETTING:
Inpatient rehabilitation. PARTICIPANTS: We included all patients with HIBI using
International Classification of Diseases, Tenth Revision, Canadian Enhancement
codes recorded at acute care admission who were >/=20 years old (N=599) and
discharged from acute care between the 2002 and 2010 fiscal years, inclusive. Six
patients were excluded from analyses because of missing data. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURE: Admission to IR. RESULTS: Of HIBI survivors
admitted to IR within 1 year of acute care discharge (n=169), most (56.2%) had an
IR admitting diagnosis indicating anoxic brain damage. Younger age, being a man,
lower comorbidity burden, longer length of stay of preceding acute care episode,
and shorter duration in special care were most predictive of admission to IR in
multivariable regression models. Women had an almost 2-fold lower incidence of
admission to IR (risk ratio, .62; 95% confidence interval, .46-.84). CONCLUSIONS:
Older age, higher comorbidity burden, and shorter lengths of stay and delayed
discharge from acute care are associated with lower incidence of IR admission for
patients with HIBI. That women are almost 2-fold less likely to receive
rehabilitation requires further investigation.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS