Disclosures: Siew Kwaon Lui, MBBS, MRCP(UK): Singapore General Hospital (Products/Services: No) (Employment)

Objective: To determine demographics of patients of all traumatic brain injury (TBI) severity admitted into an acute hospital and predictors associated with transfer to acute inpatient rehabilitation (AIR) following early screening.

Design: A retrospective study. Setting : Acute tertiary hospital. Participants : A total of 491 patients with head trauma were screened and reviewed between 1 November 2010 and 30 October 20012 by the on-duty physiatrist within 72 hours of admission to the Department of Neurosurgery (NES) ward in an acute tertiary hospital. One hundred and sixteen patients were directly transferred to AIR after the early screening and review.

Interventions: Not applicable.

Main Outcome Measures: Demographic variables; acute clinical characteristics: mechanism of injury, Glasgow Coma Scale upon admission, neuroimaging findings, and neurosurgical interventions; complications: nosocomial infections, post-traumatic seizures, deep vein thrombosis, dysautonomia and the need for tracheostomy; acute length of stay (ALOS) and discharge disposition; rehabilitation outcomes: Functional Independence Measure (FIM) and Rancho Los Amigos Scale-Revised scale.

Results: The median age of the patients was 67.0 years (IQR 50.0-77.0); 66.2% were male (n= 325). Majority of the TBI admissions were mild in severity (82.5%, n= 405). Falls were the leading mechanism of injury (76.8%, n= 377). Among patients who fell, 74.5% were > 60 years old (n= 281). Most patients were non-surgically managed (78.2%, n= 384). The ALOS (days) was 7.0 (IQR 3.0-14.0). Most were directly discharged (70.7%, n= 347) and 116 patients (23.6%) were transferred to AIR. Age, gender, severity of TBI, neurosurgical intervention, infection and total FIM were significantly associated with transfer to AIR. Multivariate analysis showed infection (OR 2.95, 95% CI 1.59-5.49) and neurosurgical intervention (OR 2.18, 95% CI 1.24-3.81) increased the odds of transfer to AIR. Conclusions: Most of the acute TBI admissions were older patients, with the predominant mechanism related to falls. Patients who had neurosurgical intervention or infection had increased likelihood of being transferred to AIR.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/demographics-of-traumatic-brain-injury-and-the-predictors-associated-with-transfer-to-acute-inpatient-rehabilitation-following-early-screening/