Rehospitalization after traumatic brain injury: a population-based study

Objective — To examine from a Canadian population-based perspective the incidence and etiology of long-term hospital utilization among persons living with traumatic brain injury (TBI) by age and sex.

Design — Retrospective cohort study.

Setting — Acute care hospitals in Ontario.

Participants — Index cases of TBI (N=29,269) were identified from the Discharge Abstract Database for fiscal years 2002/03-2009/10 and were followed up to 36 months after injury.

Interventions — Not applicable.

Main Outcome Measures — Re-hospitalizations were defined as an admission to an acute care facility that occurred up to 36 months following index injury. Diagnoses associated with subsequent re-hospitalizations were examined by age and sex.

Results — 35.5% (n=10,390) of patients with TBI were subsequently hospitalized during the 3 year follow-up period. Multivariable logistic regression (controlling for index admission hospital) identified males, older age, mechanism of injury being a fall, greater injury severity, rural residence, greater comorbidity and psychiatric comorbidity to be significant predictors of re-hospitalization in a three year period post injury. The most common causes for re-hospitalization differed by age and sex.

Conclusions — Re-hospitalizations after TBI are common. Factors associated with re-hospitalizations can inform long term post discharge planning. Findings also support examining causes for re-hospitalization by age and sex.