Abstract
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.
Keywords
List of abbreviations:
ABI (acquired brain injury), ALC (alternate level of care), HIBI (hypoxic-ischemic brain injury), ICD-10 (International Classification of Diseases, 10th Revision), IR (inpatient rehabilitation), LOS (length of stay), NTBI (nontraumatic brain injury), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 29, 2016
Footnotes
Supported by the Physicians' Services Incorporated Foundation; provision of data by the Institute for Clinical Evaluative Sciences (ICES) and the Cancer Care Ontario; ICES from an annual grant by the Ministry of Health and Long-Term Care and the Ontario Institute for Cancer Research; and by the Canadian Institutes of Health Research Research Chair in Gender, Work and Health (grant no. CGW-126580).
The opinions, results, and conclusions reported in this article are those of the authors. No endorsement by the Institute for Clinical Evaluative Sciences, Cancer Care Ontario, Ontario Institute for Cancer Research, or the Government of Ontario is intended or should be inferred.
Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions, and statements expressed herein are those of the author, and not necessarily those of the CIHI.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
