Influence of Sex and Age on Inpatient Rehabilitation Outcomes Among Older Adults With Traumatic Brain Injury
Abstract
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).
Design
Prospective case series.
Setting
Eight hundred forty-eight inpatient rehabilitation facilities that subscribe to the Uniform Data System for Medical Rehabilitation.
Participants
Patients (n=18,413) age 65 years and older admitted for inpatient rehabilitation after TBI from 2005 through 2007.
Interventions
None.
Main Outcome Measures
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.
cDepartment of Occupational Therapy, East Carolina University, Greenville, NC
dDepartment of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY
eUniform Data System for Medical Rehabilitation, Department of Rehabilitation Medicine, State University of New York at Buffalo, Buffalo, NY
Correspondence to James E. Graham, PhD, DC, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1137
Supported in part by the National Institute on Disability and Rehabilitation Research (grant no. H133G080163) and the National Institutes of Health, National Institute for Child Health and Human Development and National Institute for Neurological Disorders and Stroke (grant no. K12-H0055929).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. Granger is employed by the State University of New York at Buffalo, which is affiliated with the Uniform Data System for Medical Rehabilitation. The Uniform Data System for Medical Rehabilitation owns the copyright and trademark for the FIM instrument.
ABSTRACT