Poster 89 Changes in U.S. Acute Care Hospital Traumatic Brain Injury Discharges 1998-2008

PM&R ◽  
2011 ◽  
Vol 3 ◽  
pp. S171-S171
Author(s):  
Elliot Bodofsky ◽  
Adam Schindelheim
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital

Acute rehospitalisation during the first 3 months of in-patient rehabilitation for traumatic brain injury

2016 ◽  
Vol 40 (1) ◽  
pp. 114 ◽  
Author(s):  
Nalinda Andraweera ◽  
Richard Seemann
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Pearson Correlation ◽  
Acute Care Hospital ◽  
Functional Independence ◽  
Care Hospital ◽  
Injury Rehabilitation ◽  
Number Of Patients ◽  
Tract Infections

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. What is known about the topic? The incidence of acute rehospitalisation of patients in the community following brain injury rehabilitation is 20%–25%, with approximately half the re-admissions being for elective reasons, including orthopaedic and reconstructive surgery. What does this paper add? Unplanned acute rehospitalisation during first 3 months of in-patient rehabilitation following TBI is due to preventable causes and results in lower FIM scores on discharge. What are the implications for practitioners? An uninterrupted rehabilitation programme is vital for achieving functional outcomes.

scholarly journals Readmission to an Acute Care Hospital During Inpatient Rehabilitation for Traumatic Brain Injury

2015 ◽  
Vol 96 (8) ◽  
pp. S293-S303.e1 ◽  
Author(s):  
Flora M. Hammond ◽  
Susan D. Horn ◽  
Randall J. Smout ◽  
Cynthia L. Beaulieu ◽  
Ryan S. Barrett ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Inpatient Rehabilitation ◽  
Care Hospital

Feasibility of modifying the hospital environment to reduce the length of amnesia after traumatic brain injury: a pilot randomized controlled trial

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Natasha A Lannin ◽  
Claire Galea ◽  
Megan Coulter ◽  
Russell Gruen ◽  
Laura Jolliffe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Randomized Controlled Trial ◽  
Brain Injury ◽  
Usual Care ◽  
Acute Care ◽  
Controlled Trial ◽  
Hospital Environment ◽  
Control Group ◽  
Care Hospital ◽  
Randomized Controlled

Abstract Background Reorientation programmes have been an important component of neurotrauma rehabilitation for adults who suffer from post-traumatic amnesia (PTA) after traumatic brain injury (TBI); however, research testing the efficacy of acute programmes is limited. Objective This study aimed to determine if it is feasible to provide a standardized environmental reorientation programme to adults suffering from PTA after TBI in an acute care hospital setting, and whether it is likely to be beneficial. Methods We conducted a randomized controlled trial with concealed allocation and intention-to-treat analysis. A total of 40 participants suffering from PTA after TBI were included. The control group received usual care; the experimental group received usual care plus a standardized orientation programme inclusive of environmental cues. The primary outcome measure was time to emergence from PTA measured by the Westmead PTA Scale, assessed daily from hospital admission or on regaining consciousness. Results Adherence to the orientation programme was high, and there were no study-related adverse responses to the environmental orientation programme. Although there were no statistically significant between-group differences in time to emergence, the median time to emergence was shorter for those who received the standardized reorientation programme (9.0 (6.4–11.6) versus 13.0 (4.5–21.5) days). Multivariate analysis showed that the Glasgow Coma Scale (GCS) at scene (P = 0.041) and GCS at arrival at hospital (P = 0.0001) were significant factors contributing to the longer length of PTA. Conclusion Providing an orientation programme in acute care is feasible for adults suffering from PTA after TBI. A future efficacy trial would require 216 participants to detect a between-group difference of 5 days with an alpha of 0.05 and a power of 80%.

Comparative Evaluation of Malnutrition Screening in Oncology Patients in an Acute Care Hospital: A Pilot Study

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Sinha Chandni Sen ◽  
LaSalle Colette ◽  
Argabright Debra ◽  
Hollenbeck Clarie B
Keyword(s):  
Pilot Study ◽  
Acute Care ◽  
Comparative Evaluation ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Oncology Patients

A Taxonomy for Psycho-Oncological Intervention Techniques in an Acute Care Hospital in Germany

2021 ◽  
pp. 1-7
Author(s):  
Martina Madl ◽  
Marietta Lieb ◽  
Katharina Schieber ◽  
Tobias Hepp ◽  
Yesim Erim
Keyword(s):  
Acute Care ◽  
Interrater Reliability ◽  
Acute Care Hospital ◽  
Future Research ◽  
Systematic Research ◽  
Care Hospital ◽  
Certification System ◽  
Stepwise Procedure ◽  
Further Development

<b><i>Background:</i></b> Due to the establishment of a nationwide certification system for cancer centers in Germany, the availability of psycho-oncological services for cancer patients has increased substantially. However, little is known about the specific intervention techniques that are applied during sessions in an acute care hospital, since a standardized taxonomy is lacking. With this study, we aimed at the investigation of psycho-oncological intervention techniques and the development of a comprehensive and structured taxonomy thereof. <b><i>Methods:</i></b> In a stepwise procedure, a team of psycho-oncologists generated a data pool of interventions and definitions that were tested in clinical practice during a pilot phase. After an adaptation of intervention techniques, interrater reliability (IRR) was attained by rating 10 previously recorded psycho-oncological sessions. A classification of interventions into superordinate categories was performed, supported by cluster analysis. <b><i>Results:</i></b> Between April and June 2017, 980 psycho-oncological sessions took place. The experts agreed on a total number of 22 intervention techniques. An IRR of 89% for 2 independent psycho-oncological raters was reached. The 22 techniques were classified into 5 superordinate categories. <b><i>Discussion/Conclusion:</i></b> We developed a comprehensive and structured taxonomy of psycho-oncological intervention techniques in an acute care hospital that provides a standardized basis for systematic research and applied care. We expect our work to be continuously subjected to further development: future research should evaluate and expand our taxonomy to other contexts and care settings.

scholarly journals Cognitive and Functional Impairment of Hospitalized Patients over 65 Years of Age

2013 ◽  
Vol 4 (1) ◽  
pp. 5-18
Author(s):  
Mª José Calero-García ◽  
Alfonso J. Cruz Lendínez
Keyword(s):  
Cognitive Impairment ◽  
Marital Status ◽  
Acute Care ◽  
Functional Impairment ◽  
Acute Care Hospital ◽  
Education Level ◽  
Care Hospital ◽  
Elderly Men ◽  
Time Of Admission ◽  
The Relationship

The first objective of this research is to establish and study how the different stages of cognitive impairment and the levels of dependence evolve in patients over 65 years of age, admitted to an acute care hospital, as well as the relationship between these factors and the different social and demographical variables. The results show that the level of dependence decreases suddenly at the time of admission and undergoes a slight recovery at the time of discharge. Although this recovery continues at home after discharge, patients do not get the same level of independence that they used to have before admission. In addition, significant differences in terms of age, marital status and education level were found. In general, our results show that elderly men over 80 years of age, without no education and widowers are more likely to suffer from severe cognitive impairment and be more functionally dependent when admitted to hospital.

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