Exploring variables associated with rehabilitation length of stay in brain injuries patients.

BACKGROUND: The impact of outcome measure as early variables on rehabilitation length of stay (LOS) in traumatic brain injury (TBI) patients remains poorly investigated.

AIM: To investigate: 1) the association between LOS and motor and functional outcomes; 2) the predictive factors of LOS in TBI patients admitted to a rehabilitation center.

DESIGN: Retrospective study.

SETTING: Inpatient TBI Rehabilitation Centre.

POPULATIONS: 241 TBI patients (190 males and 51 females, mean age 43.61±19.4 years, initial Glasgow Coma Scale of 6.96±3.39).

METHODS: We recorded demographic characteristics (age, sex, setting and LOS in the acute phase, rehabilitation LOS) and outcome measures (Glasgow Outcome Scale, Disability Rating Scale, Levels of Cognitive Functioning, Functional Independence Measure).

RESULTS: Average rehabilitation LOS was 58.82±58 days; 191 (79%) subjects were discharged from the rehabilitation center within 90 days. Rehabilitation LOS was significantly correlated with acute-care LOS (P=0.001) and Glasgow Coma Scale, but not with patients' age (P=0.250) or sex (P= 0.348). Rehabilitation LOS was significantly correlated with functional and cognitive admission outcome scores but not with gains during rehabilitation. Rehabilitation LOS was significantly less in the group of patients that returned back home respect to others. Regression analysis also illustrated that longer acute-care LOS was independently associated with significantly increased rehabilitation LOS (P<0.001).

CONCLUSION: Our retrospective study suggests that rehabilitation LOS in TBI patients is correlated with timing of and score at admission to the rehabilitation setting rather than with gains in functional outcome.

CLINICAL REHABILITATION IMPACT: This result may help to optimize inpatient service utilization, especially in term of LOS.