Rehospitalization in the First Year Following Veteran and Service Member TBI: A VA TBI Model Systems Study

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Abstract

Objective:

To determine the incidence and causes of rehospitalization following military or Veteran traumatic brain injury (TBI).

Setting:

Department of Veterans Affairs (VA) Veterans Health Administration Polytrauma Rehabilitation Centers (VHA PRCs).

Participants:

Consecutive sample of VHA TBI Model System participants (N = 401).

Design:

Prospective observational cohort study.

Main Measures:

Number and type of rehospitalizations in first year post-TBI.

Results:

Forty-one percent of 401 participants were rehospitalized. Rehospitalization status was associated with greater injury severity and receipt of TBI while active duty. Of those rehospitalized, 30% had 2 or more readmissions. Participants experiencing multiple rehospitalizations (2+) were more likely to have sustained their TBI during deployment than those with none or single rehospitalization. This group also sustained more severe injuries and spent more time in VA PRC inpatient rehabilitation. Common reasons for rehospitalization included inpatient rehabilitation (33%), unspecified (26%), orthopedic (10%), seizures (8%), infection (8%), and psychiatric (7%).

Conclusion:

This is the first study examining military and Veteran rehospitalization following TBI requiring inpatient rehabilitation at a VA PRC. Findings indicate frequent rehospitalizations in the first year postinjury, suggesting the need for preventive models of health maintenance following inpatient rehabilitation discharge. Greater surveillance of those with deployment-related TBI or active duty at the time of injury and greater TBI severity may be warranted.

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