Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia 30322, USA.
J Head Trauma Rehabil. 2010 Jan-Feb;25(1):52-60. doi: 10.1097/HTR.0b013e3181c29952.
To examine change in residence following traumatic brain injury (TBI) as a function of preinjury residential status, demographic factors, and injury-related characteristics.
Prospective, observational study.
Inpatient, comprehensive rehabilitation programs for persons with TBI.
A total of 7925 patients with moderate or severe TBI receiving acute rehabilitation, and enrolled in the TBI Model Systems National Database.
Preinjury and discharge residential status determined during rehabilitation, and at 1, 2, and 5 years postinjury by telephone interview. Variables contributing to residential status included injury severity, demographic information, and functional status.
There was significant change in residence across 5 years characterized by discharge to a less independent residence following injury, with a return to a more independent residence over time. The most significant transition took place in the first year after injury. Residence prior to injury was the strongest predictor of residence after injury. Age and race were significantly associated with residence following TBI, with increasing age related to more independent residence, and whites more likely to live independently than are African Americans. Severity of injury had little impact, although functional status at rehabilitation discharge was associated with residence, with higher functional status associated with a more independent residence.
Among persons who received acute rehabilitation for TBI, 35.4% were discharged from rehabilitation to a setting different from the one in which they resided before injury. The degree of change varied on the basis of preinjury residence. Overall, the results indicate that while many patients are discharged to a different residential setting than prior to their injury, some patients recover to the point where they are able to return to their premorbid residential setting. The most substantial change was for those living alone at the time of injury, and within the first year of injury.
研究创伤性脑损伤（TBI）后居住地的变化情况，探讨其与受伤前居住地、人口统计学因素和与损伤相关的特征之间的关系。
前瞻性、观察性研究。
TBI 模型系统国家数据库纳入的接受急性康复治疗的、入住综合性康复项目的中度或重度 TBI 患者。
共纳入 7925 例 TBI 患者，这些患者在康复期间以及受伤后 1、2、5 年通过电话访谈确定受伤前和出院后的居住地。影响居住地的变量包括损伤严重程度、人口统计学信息和功能状态。
5 年内居住地发生显著变化，受伤后患者出院时居住在较不独立的环境中，随着时间的推移，逐渐回归到更独立的居住环境。最显著的转变发生在受伤后的第一年。受伤前的居住地是受伤后居住地的最强预测因素。年龄和种族与 TBI 后居住地显著相关，年龄越大，居住越独立，白人比非裔美国人更有可能独立居住。损伤严重程度的影响较小，但康复出院时的功能状态与居住地相关，功能状态越高，居住越独立。
在接受急性 TBI 康复治疗的患者中，35.4%的患者从康复治疗出院后，居住地与受伤前不同。变化的程度基于受伤前的居住地而有所不同。总体而言，结果表明，尽管许多患者出院后的居住环境与受伤前不同，但一些患者能够恢复到能够回到受伤前居住地的程度。变化最大的是那些受伤时独居的患者，以及在受伤后的第一年。
