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Racial Differences in Discharge Location After a Traumatic Brain Injury Among Older Adults

Published:April 04, 2019DOI:https://doi.org/10.1016/j.apmr.2019.03.008

      Abstract

      Objective

      To determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center.

      Design

      Retrospective cohort study.

      Setting

      R Adams Cowley Shock Trauma Center.

      Participants

      Black and white adults aged ≥65 years treated for TBI between 1998 and 2012 and discharged to home without services or inpatient rehabilitation (N=2902).

      Main Outcome Measures

      We assessed the association between race and discharge location via logistic regression. Covariates included age, sex, Abbreviated Injury Scale-Head score, insurance type, Glasgow Coma Scale score, and comorbidities.

      Results

      There were 2487 (86%) whites and 415 blacks (14%) in the sample. A total of 1513 (52%) were discharged to inpatient rehabilitation and 1389 (48%) were discharged home without services. In adjusted logistic regression, blacks were more likely to be discharged to inpatient rehabilitation than to home without services compared to whites (odds ratio 1.34, 95% confidence interval, 1.06-1.70).

      Conclusions

      In this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites.

      Keywords

      List of abbreviations:

      95% CI (95% confidence interval), AIS (Abbreviated Injury Scale), AIS-H (Abbreviated Injury Scale-Head), GCS (Glasgow Coma Scale), ICU (intensive care unit), ISS (injury severity score), OR (odds ratio), STC (Shock Trauma Center), TBI (traumatic brain injury)
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