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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 3 of 3 Research Studies DisplayedWu A, Zhou J, Quinlan N
Early palliative care consultation offsets hospitalization duration and costs for elderly patients with traumatic brain injuries: insights from a level 1 trauma center.
The purpose of this study was to identify variables and outcomes related to inpatient palliative care (PC) consultation for patients age 65+ with traumatic brain injuries (TBI). The researchers included individuals over age 65 presenting from January 2013-September 2020 with TBI and intracranial hemorrhage. The study found that inpatient PC consultation was uncommon; with only 4% of 576 patients receiving. Features associated with likelihood of consultation were severe TBI and pre-existing dementia. Patients with PC consults had longer overall and intensive care unit (ICU) length of stays (LOS), more days intubated and higher costs. However, those patients with earlier-than-average PC consultation had shorter overall and ICU LOS as well as fewer ventilator days on a ventilator and lower costs. The study concluded that older patients with TBI have a greater likelihood of receiving PC consultation based on pre-existing dementia and severe TBI and patients with PC consultations had worse LOS and higher costs, but those impacts were diminished by earlier involvement from the PC.
AHRQ-funded; HS028747.
Citation: Wu A, Zhou J, Quinlan N .
Early palliative care consultation offsets hospitalization duration and costs for elderly patients with traumatic brain injuries: insights from a level 1 trauma center.
J Clin Neurosci 2023 Feb; 108:1-5. doi: 10.1016/j.jocn.2022.12.013..
Keywords: Elderly, Palliative Care, Hospitalization, Brain Injury
Evans E, Krebill C, Gutman R
Functional motor improvement during inpatient rehabilitation among older adults with traumatic brain injury.
This retrospective cohort study’s goal was to describe the proportion of older adults with traumatic brain injury (TBI) who exhibited minimal detectable change (MDC) and a minimally clinically important difference (MCID) in motor function from inpatient rehabilitation facility (IRF) admission to discharge; and to identify characteristics associated with clinically meaningful improvement in motor function and better discharge functional status. This study used Medicare administrative data probabilistically linked to the National Trauma Data Bank. The authors found that from IRF admission to discharge 84% of patients achieved the MDC threshold, and 68% of patients achieved the MCID threshold for FIM-M scores. A higher probability of achieving the MCID for IM-M scores included better admission motor and cognitive function, lower comorbidity burden, and a length of stay longer than 10 days but only among individuals with lower admission motor function. Older age was associated with a lower FIM-M discharge score but was not associated with the probability of achieving the MCID in FIM-M score.
AHRQ-funded; HS000011.
Citation: Evans E, Krebill C, Gutman R .
Functional motor improvement during inpatient rehabilitation among older adults with traumatic brain injury.
PM R 2022 Apr; 14(4):417-27. doi: 10.1002/pmrj.12644..
Keywords: Elderly, Rehabilitation, Brain Injury, Inpatient Care
Kumar RG, Zhang W, Evans E
Research letter: characterization of older adults hospitalized with traumatic brain injury admitted to long-term acute care hospitals.
The objective of this study was to describe patient, hospital, and geographic characteristics of older adult Medicare beneficiaries who were hospitalized with traumatic brain injury (TBI) then admitted to long-term acute care hospitals. Participants were predominantly White males with an average age of 77.1. Average acute hospital length of stay was 19.4 days. Only 4% of patients were discharged home after a long-term acute care hospital stay; the primary discharge disposition was to skilled nursing facilities. Geographic analyses indicated that Southern and Midwestern states had the greatest number of long-term acute care hospital facilities and highest proportion of admissions. The authors concluded that more research is needed to understand long-term functional outcomes among this population.
AHRQ-funded; HS000011.
Citation: Kumar RG, Zhang W, Evans E .
Research letter: characterization of older adults hospitalized with traumatic brain injury admitted to long-term acute care hospitals.
J Head Trauma Rehabil 2022 Mar-Apr; 37(2):89-95. doi: 10.1097/htr.0000000000000685..
Keywords: Elderly, Brain Injury, Long-Term Care