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Effects of Age and Sex on Hospital Readmission in Traumatic Brain Injury

Published:January 04, 2018DOI:https://doi.org/10.1016/j.apmr.2017.12.006

      Abstract

      Objective

      To investigate the effects of age and sex on 30-, 60-, and 90-day hospital readmission after acute hospital discharge for individuals with traumatic brain injury (TBI).

      Design

      Retrospective cohort study.

      Setting

      Acute hospitals and postacute discharge settings.

      Participants

      Individuals (N=52,877) with Diagnosis Related Group codes of TBI, who were divided into 4 age groups: 18 to 40, 41 to 65, 66 to 75, and ≥76 years.

      Interventions

      Not applicable.

      Main Outcome Measures

      All-cause hospital readmission.

      Results

      Sex differences in 30-, 60-, and 90-day hospital readmission were found among all age groups (P<.05 for all). The largest sex differences in hospital readmission were in the 2 oldest groups (66–75 and ≥76y). For both sexes, the oldest group (≥76y) had the highest adjusted 90-day readmission risk (eg, 90-d readmission: odds ratio, 2.32 [95% confidence interval, 2.01–2.69] for men; odds ratio, 1.96 [95% confidence interval, 1.59–2.43] for women). Among those readmitted within 90 days, the youngest group (18–40y) had the highest cumulative readmission percentage (35% for both sexes) within the first week of hospital discharge.

      Conclusions

      Age and sex were significantly associated with hospital readmission during the first 90 days postdischarge in our TBI sample. Specifically, those aged 66 to 75 or ≥76 years had the highest readmission risk over 90 days for both sexes. The findings suggest that clinicians should consider age and sex in discharge planning and for the entire episode of care for the population with TBI.

      Keywords

      List of abbreviations:

      DRG (Diagnosis Related Group), HCUP (Healthcare Cost and Utilization Project), ICF (intermediate care facility), NRD (Nationwide Readmissions Database), OR (odds ratio), SNF (skilled nursing facility), TBI (traumatic brain injury)
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