Predictors for 30-Day Readmissions After Traumatic Brain Injury. Issue 3 (May 2021)

• Record Type: Journal Article
• Authors: Pollifrone, Maria; Callender, Librada; Bennett, Monica; Driver, Simon; Petrey, Laura; Hamilton, Rita; Dubiel, Rosemary
• Is Part Of: Journal of head trauma rehabilitation. Volume 36:Issue 3(2021)
• Publication Date: 2021-05
• Subjects: 30-day readmissions -- healthcare utilization -- traumatic brain injury; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000630
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : Objective: To examine predictors for 30-day readmission post-onset of traumatic brain injury (TBI) after initial trauma hospitalization. Design: Retrospective cohort. Participants: In total, 5284 patients with an acute TBI admitted from January 1, 2006, through December 31, 2015. Methods: Demographic and clinical data after initial TBI onset were extracted from the local trauma registry and matched with the Dallas-Fort Worth Hospital Council registry. Multiple logistic regression analysis was used to determine factors significantly associated with 30-day readmission. Top diagnosis codes for 30-day readmission were also described. Results: Patients were primarily male (64.6%), non-Hispanic White (47.6%), uninsured (35.4%), and aged 46.1 ± 23.3 years. In total, 448 patients (8.5%) had a 30-day readmission. Median cumulative charges for each readmitted subject was $34 313. Factors significantly associated with 30-day readmission were falling as the cause of injury, having increased Charlson Comorbidity Index and Injury Severity Score, and discharging to a skilled nursing facility or long-term acute care. Being uninsured was associated with decreased odds of a 30-day readmission. Top diagnosis codes among the readmission visits included cardiac codes (57.7%), fluid and acid-base disorders (54.8%), and hypertension (50.1%). Conclusion: These data highlight those at risk for 30-day readmission across a diverse population of TBI at a large medical center. Interventions such as health literacy education or patient navigation may help mitigate 30-day readmission for at-risk patients.