Sex-Specific Predictors of Inpatient Rehabilitation Outcomes After Traumatic Brain Injury

Overview

Journal Arch Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2016 Feb 3

PMID 26836952

Citations 15

Authors

Vincy Chan

Tatyana Mollayeva

Kenneth J Ottenbacher

Angela Colantonio

Affiliations

Soon will be listed here.

Abstract

Objective: To identify sex-specific predictors of inpatient rehabilitation outcomes among patients with a traumatic brain injury (TBI) from a population-based perspective.

Design: Retrospective cohort study.

Setting: Inpatient rehabilitation.

Participants: Patients in inpatient rehabilitation for a TBI within 1 year of acute care discharge between 2008/2009 and 2011/2012 (N=1730, 70% men, 30% women).

Interventions: None.

Main Outcome Measures: Inpatient rehabilitation length of stay, total FIM score, and motor and cognitive FIM ratings at discharge.

Results: Sex, as a covariate in multivariable linear regression models, was not a significant predictor of rehabilitation outcomes. Although many of the predictors examined were similar across men and women, sex-specific multivariable models identified some predictors of rehabilitation outcome that are specific for men and women; mechanism of injury (P<.0001) was a significant predictor of functional outcome only among women, whereas comorbidities (P<.0001) was a significant predictor for men only.

Conclusions: Predictors of outcomes after inpatient rehabilitation differed by sex, providing evidence for a sex-specific approach in planning and resource allocation for inpatient rehabilitation services for patients with TBI.

Citing Articles

Sex/gender differences in service use patterns, clinical outcomes and mortality risk for adults with acquired brain injury: a retrospective cohort study (ABI-RESTART).

Mann G, Troeung L, Martini A J Rehabil Med. 2023; 55:jrm5303.

PMID: 37698453 PMC: 10506514. DOI: 10.2340/jrm.v55.5303.

[Predictors of the duration of post-traumatic amnesia following traumatic brain injury].

Garcia-Molina A, Andreu-Tello A, Vilageliu-Jorda E, Ensenat-Cantallops A Rev Neurol. 2022; 75(12):361-368.

PMID: 36514202 PMC: 10280705. DOI: 10.33588/rn.7512.2022249.

Social determinants of health associated with psychological distress stratified by lifetime traumatic brain injury status and sex: Cross-sectional evidence from a population sample of adults in Ontario, Canada.

Chan V, Marcus L, Burlie D, Mann R, Toccalino D, Cusimano M PLoS One. 2022; 17(8):e0273072.

PMID: 36044420 PMC: 9432736. DOI: 10.1371/journal.pone.0273072.

Acute Inpatient Rehabilitation Improves Function Independent of Comorbidities in Medically Complex Patients.

Zhang S, Lin D, Wright M, Swallow N Arch Rehabil Res Clin Transl. 2022; 4(2):100178.

PMID: 35756989 PMC: 9214302. DOI: 10.1016/j.arrct.2022.100178.

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event.

Mollayeva T, Tran A, Chan V, Colantonio A, Sutton M, Escobar M Sci Rep. 2022; 12(1):5584.

PMID: 35379824 PMC: 8980052. DOI: 10.1038/s41598-022-08782-0.

References

Baker D, Hayes R, FORTIER J . Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998; 36(10):1461-70. DOI: 10.1097/00005650-199810000-00004. View

Slewa-Younan S, Green A, Baguley I, Gurka J, Marosszeky J . Sex differences in injury severity and outcome measures after traumatic brain injury. Arch Phys Med Rehabil. 2004; 85(3):376-9. DOI: 10.1016/j.apmr.2003.05.007. View

Humphreys I, Wood R, Phillips C, Macey S . The costs of traumatic brain injury: a literature review. Clinicoecon Outcomes Res. 2013; 5:281-7. PMC: 3699059. DOI: 10.2147/CEOR.S44625. View

Whiteneck G, Brooks C, Mellick D, Harrison-Felix C, Terrill M, Noble K . Population-based estimates of outcomes after hospitalization for traumatic brain injury in Colorado. Arch Phys Med Rehabil. 2004; 85(4 Suppl 2):S73-81. DOI: 10.1016/j.apmr.2003.08.107. View

Corrigan J, Lineberry L, Komaroff E, Langlois J, Selassie A, Wood K . Employment after traumatic brain injury: differences between men and women. Arch Phys Med Rehabil. 2007; 88(11):1400-9. DOI: 10.1016/j.apmr.2007.08.006. View

Colantonio A, Gerber G, Bayley M, Deber R, Kim H, Yin J . Who waits for inpatient rehabilitation services in Canada after neurotrauma? A population based-study. J Rehabil Med. 2010; 42(8):773-9. DOI: 10.2340/16501977-0582. View

Malmusi D, Vives A, Benach J, Borrell C . Gender inequalities in health: exploring the contribution of living conditions in the intersection of social class. Glob Health Action. 2014; 7:23189. PMC: 3927744. DOI: 10.3402/gha.v7.23189. View

Granger C, Markello S, Graham J, Deutsch A, Reistetter T, Ottenbacher K . The uniform data system for medical rehabilitation: report of patients with traumatic brain injury discharged from rehabilitation programs in 2000-2007. Am J Phys Med Rehabil. 2010; 89(4):265-78. PMC: 2918420. DOI: 10.1097/PHM.0b013e3181d3eb20. View

Haag H, Caringal M, Sokoloff S, Kontos P, Yoshida K, Colantonio A . Being a Woman With Acquired Brain Injury: Challenges and Implications for Practice. Arch Phys Med Rehabil. 2015; 97(2 Suppl):S64-70. DOI: 10.1016/j.apmr.2014.12.018. View

10.

Wright D, Espinoza T, Merck L, Ratcliff J, Backster A, Stein D . Gender differences in neurological emergencies part II: a consensus summary and research agenda on traumatic brain injury. Acad Emerg Med. 2014; 21(12):1414-20. PMC: 4311997. DOI: 10.1111/acem.12532. View

11.

Hukkelhoven C, Steyerberg E, Habbema J, Farace E, Marmarou A, Murray G . Predicting outcome after traumatic brain injury: development and validation of a prognostic score based on admission characteristics. J Neurotrauma. 2005; 22(10):1025-39. DOI: 10.1089/neu.2005.22.1025. View

12.

Sarver J, Baker D . Effect of language barriers on follow-up appointments after an emergency department visit. J Gen Intern Med. 2000; 15(4):256-64. PMC: 1495439. DOI: 10.1111/j.1525-1497.2000.06469.x. View

13.

Chen A, Chan V, Zagorski B, Parsons D, Colantonio A . Factors associated with living setting at discharge from inpatient rehabilitation after acquired brain injury in Ontario, Canada. J Rehabil Med. 2014; 46(2):144-52. DOI: 10.2340/16501977-1243. View

14.

John-Baptiste A, Naglie G, Tomlinson G, Alibhai S, Etchells E, Cheung A . The effect of English language proficiency on length of stay and in-hospital mortality. J Gen Intern Med. 2004; 19(3):221-8. PMC: 1492154. DOI: 10.1111/j.1525-1497.2004.21205.x. View

15.

Covassin T, Bay E . Are there gender differences in cognitive function, chronic stress, and neurobehavioral symptoms after mild-to-moderate traumatic brain injury?. J Neurosci Nurs. 2012; 44(3):124-33. DOI: 10.1097/JNN.0b013e318252737d. View

16.

Babitsch B, Gohl D, von Lengerke T . Re-revisiting Andersen's Behavioral Model of Health Services Use: a systematic review of studies from 1998-2011. Psychosoc Med. 2012; 9:Doc11. PMC: 3488807. DOI: 10.3205/psm000089. View

17.

Colantonio A, Saverino C, Zagorski B, Swaine B, Lewko J, Jaglal S . Hospitalizations and emergency department visits for TBI in Ontario. Can J Neurol Sci. 2010; 37(6):783-90. DOI: 10.1017/s0317167100051441. View

18.

Freeman J, Kadiyala S, Bell J, Martin D . The causal effect of health insurance on utilization and outcomes in adults: a systematic review of US studies. Med Care. 2008; 46(10):1023-32. DOI: 10.1097/MLR.0b013e318185c913. View

19.

Graham J, Radice-Neumann D, Reistetter T, Hammond F, Dijkers M, Granger C . Influence of sex and age on inpatient rehabilitation outcomes among older adults with traumatic brain injury. Arch Phys Med Rehabil. 2010; 91(1):43-50. PMC: 4148208. DOI: 10.1016/j.apmr.2009.09.017. View

20.

Colantonio A, Mar W, Escobar M, Yoshida K, Velikonja D, Rizoli S . Women's health outcomes after traumatic brain injury. J Womens Health (Larchmt). 2010; 19(6):1109-16. DOI: 10.1089/jwh.2009.1740. View