Abstract
Arango-Lasprilla JC, Ketchum JM, Cifu D, Hammond F, Castillo C, Nicholls E, Watanabe
T, Lequerica A, Deng X. Predictors of extended rehabilitation length of stay after
traumatic brain injury.
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.
Interventions
Not applicable.
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.
Key Words
List of Abbreviations:
AUC (area under the curve), DAI (diffuse axonal injury), GCS (Glasgow Coma Scale), GED (general equivalency diploma), LOS (length of stay), MVC (motor vehicle collision), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model System)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (grant nos. H133A070036, H133A21943-16, and H133A07003).
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.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
