Article

OBJECTIVE: To develop a prediction rule for acutely identifying patients at risk
for extended rehabilitation length of stay (LOS) after traumatic brain injury
(TBI) by using demographic and injury characteristics. DESIGN: Retrospective
cohort study. SETTING: Traumatic Brain Injury Model Systems. PARTICIPANTS: Sample
of TBI survivors (N=7284) with injuries occurring between 1999 and 2009.
MAIN OUTCOME MEASURES: Extended rehabilitation LOS
defined as 67 days or longer. RESULTS: A multivariable model was built containing
FIM motor and cognitive scores at admission, preinjury level of education, cause
of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor
source. The model had good calibration, excellent discrimination (area under the
receiver operating characteristic curve = .875), and validated well. Based on
this model, a formula for determining the probability of extended rehabilitation
LOS and a prediction rule that classifies patients with predicted probabilities
greater than 4.9% as at risk for extended rehabilitation LOS were developed.
CONCLUSIONS: The current predictor model for TBI survivors who require extended
inpatient rehabilitation may allow for enhanced rehabilitation team planning,
improved patient and family education, and better use of health care resources.
Cross-validation of this model with other TBI populations is recommended.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS