Acute rehospitalisation during the first 3 months of in-patient rehabilitation for traumatic brain injury
Acute rehospitalisation during the first 3 months of in-patient rehabilitation for traumatic brain injury
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DOI：
10.1071/ah15062
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发表时间：
2016-01-01
影响因子：
1.8
通讯作者：
Seemann, Richard
中科院分区：
文献类型：
--
作者：
Andraweera, Nalinda;Seemann, Richard
客观的。在住院康复期间意外再次入院急症护理医院会导致康复计划中断并增加医疗费用。本研究的目的是确定创伤性脑损伤 (TBI) 住院康复前 3 个月内因急性再入院而导致康复中断的频率、原因和持续时间，并探讨急性再住院持续时间与出院功能独立测量 (FIM) 评分之间的相关性。 方法。对 2009 年 1 月至 2013 年 8 月期间在新西兰奥克兰一家康复医院接受 TBI 住院康复治疗的患者进行了一项回顾性研究。从电子病历中获得了急性再住院的持续时间和原因以及入院和出院 FIM 评分的数据。采用Pearson相关性评估急性再住院时间与出院FIM评分之间的关系。结果。在 628 名接受脑损伤康复治疗的患者中，71 名（11.3%）在头 3 个月内需要急性再住院。急性再住院的主要原因是可预防的医疗原因（43.8%），包括尿路感染、呼吸道感染和冠状动脉疾病。在急性再入院的患者中，76.6%是在进入康复中心的第一个月内，46.6%需要在急症护理医院住院治疗>5天。在急症护理医院的住院时间与出院 FIM 评分之间存在中强负相关（r = -0.412；P = 0.0005）。结论。由于可预防的医疗原因，大量 TBI 后入院住院康复的患者需要急性再住院。由于急性再住院的持续时间对康复功能获得具有负面影响，因此需要进一步研究和优化预防措施和监测。
Objective. Unplanned re-admission to acute care hospitals during in-patient rehabilitation causes disruption to the rehabilitation program and increases the cost of health care. The aims of the present study were to identify the frequency, reasons and duration of disruption to rehabilitation because of acute re-admissions during the first 3 months of in-patient rehabilitation for traumatic brain injury (TBI) and to investigate the correlation between the duration of acute rehospitalisation and the discharge functional independence measure (FIM) score.Methods. A retrospective study was conducted on patients admitted for in-patient rehabilitation following TBI to a rehabilitation hospital in Auckland, New Zealand, between January 2009 and August 2013. Data on duration and reasons for acute rehospitalisation, as well as admission and discharge FIM scores, were obtained from electronic patient records. Pearson correlation was used to evaluate the relationship between the duration of acute rehospitalisation and the discharge FIM score.Results. Of the 628 patients admitted for brain injury rehabilitation, 71 (11.3%) required acute rehospitalisation within the first 3 months. The main reasons for acute rehospitalisation were preventable medical causes (43.8%), including urinary tract infections, respiratory tract infections and coronary artery disease. Of the acute re-admissions, 76.6% were within the first month of admission to the rehabilitation centre and 46.6% needed in-patient treatment in the acute care hospital for >5 days. There was a moderately strong negative correlation between the duration of stay in the acute care hospital and the discharge FIM score (r = -0.412; P = 0.0005).Conclusion. A significant number of patients admitted for in-patient rehabilitation following TBI require acute rehospitalisation due to preventable medical causes. Because the duration of acute rehospitalisation has a negative impact on rehabilitation functional gain, preventive measures and surveillance need to be further investigated and optimised.