Rehabilitation Sciences Institute (Ms Zarshenas, and Drs Colantonio, Jaglal, and Cullen), Occupational Science and Occupational Therapy (Dr Colantonio), and Dalla Lana School of Public Health (Dr Colantonio), University of Toronto, Ontario, Canada; and University Health Network, Toronto Rehabilitation Institute, Ontario, Canada (Drs Zarshenas, Colantonio, Alavinia, Jaglal, Tam, and Cullen).
J Head Trauma Rehabil. 2019 Jan/Feb;34(1):52-64. doi: 10.1097/HTR.0000000000000403.
To systematically review studies on clinical and nonclinical predictors of discharge destination from acute care in patients with traumatic brain injury.
The search was conducted using 7 databases up to December 2016. A systematic review and in-depth quality synthesis were conducted on eligible articles that met the inclusion criteria.
The search yielded 8503 articles of which 18 studies met the inclusion criteria. This study demonstrated that a larger proportion of patients with traumatic brain injury were discharged home. The main predictors of discharge to a setting with rehabilitation services versus home included increasing age, white and non-Hispanic race/ethnicity, having insurance coverage, greater severity of the injury, and longer acute care length of stay. Age was the only consistent factor that was negatively associated with discharge to inpatient rehabilitation facilities versus other institutions.
Results of this study support healthcare providers in providing consultation to patients about the expected next level of cares while considering barriers that may helpful in effective discharge planning, decreasing length of stay and saving resources. These findings also suggest the need for further studies with a stronger methodology on the contribution of patients and families/caregivers to distinguish the predictors of discharge to dedicated rehabilitation facilities.
系统回顾外伤性脑损伤患者从急性护理出院的临床和非临床预测因素的研究。
检索 7 个数据库，截至 2016 年 12 月。对符合纳入标准的合格文章进行系统评价和深入的质量综合分析。
检索出 8503 篇文章，其中 18 项研究符合纳入标准。这项研究表明，外伤性脑损伤患者出院回家的比例较高。与家庭相比，预测出院至康复服务机构的主要预测因素包括年龄较大、白人及非西班牙裔种族/民族、有保险、损伤严重程度更高、急性护理住院时间更长。年龄是唯一与住院康复设施相比其他机构的出院呈负相关的一致因素。
本研究结果支持医疗保健提供者在向患者提供咨询时，考虑到可能有助于有效出院计划、缩短住院时间和节省资源的障碍，了解预期的下一级护理。这些发现还表明，需要进一步进行更具方法学的研究，以探讨患者和家庭/照顾者对专门康复设施出院预测因素的贡献。
