Rehospitalization After Traumatic Brain Injury: A Population-Based Study

Abstract

Objective: To examine, from a Canadian population-based perspective, the incidence and etiology of long-term hospital utilization among persons living with traumatic brain injury (TBI) by age and sex.

Design: Retrospective cohort study.

Setting: Acute care hospitals.

Participants: Index cases of TBI (N=29,269) were identified from the Discharge Abstract Database for fiscal years 2002/2003 through 2009/2010 and were followed-up until 36 months after injury.

Interventions: Not applicable.

Main outcome measures: Rehospitalization was defined as admission to an acute care facility that occurred up to 36 months after index injury. Diagnoses associated with subsequent rehospitalization were examined by age and sex.

Results: Of the patients with TBI, 35.5% (n=10,390) were subsequently hospitalized during the 3-year follow-up period. Multivariable logistic regression (controlling for index admission hospital) identified men, older age, mechanism of injury being a fall, greater injury severity, rural residence, greater comorbidity, and psychiatric comorbidity to be significant predictors of rehospitalization in a 3-year period postinjury. The most common causes for rehospitalization differed by age and sex.

Conclusions: Rehospitalization after TBI is common. Factors associated with rehospitalization can inform long-term postdischarge planning. Findings also support examining causes for rehospitalization by age and sex.

Keywords: Brain injuries; Patient readmission, hospital readmission; Rehabiliation; Risk factors.