老年人创伤性脑损伤后出院地点的种族差异。
Racial Differences in Discharge Location After a Traumatic Brain Injury Among Older Adults.
机构信息
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
Department of Care Management, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD.
出版信息
Arch Phys Med Rehabil. 2019 Sep;100(9):1622-1628. doi: 10.1016/j.apmr.2019.03.008. Epub 2019 Apr 4.
OBJECTIVE
To determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center.
DESIGN
Retrospective cohort study.
SETTING
R Adams Cowley Shock Trauma Center.
PARTICIPANTS
Black and white adults aged ≥65 years treated for TBI between 1998 and 2012 and discharged to home without services or inpatient rehabilitation (N=2902).
MAIN OUTCOME MEASURES
We assessed the association between race and discharge location via logistic regression. Covariates included age, sex, Abbreviated Injury Scale-Head score, insurance type, Glasgow Coma Scale score, and comorbidities.
RESULTS
There were 2487 (86%) whites and 415 blacks (14%) in the sample. A total of 1513 (52%) were discharged to inpatient rehabilitation and 1389 (48%) were discharged home without services. In adjusted logistic regression, blacks were more likely to be discharged to inpatient rehabilitation than to home without services compared to whites (odds ratio 1.34, 95% confidence interval, 1.06-1.70).
CONCLUSIONS
In this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites.
目的
在一家 1 级创伤中心治疗创伤性脑损伤（TBI）的老年患者中，确定种族间出院地点是否存在差异。
设计
回顾性队列研究。
地点
R 亚当斯考利休克创伤中心。
参与者
1998 年至 2012 年间在 R 亚当斯考利休克创伤中心接受 TBI 治疗且未接受服务或住院康复治疗而出院回家的年龄≥65 岁的黑人和白人成年人（N=2902）。
主要观察指标
我们通过逻辑回归评估种族与出院地点之间的关系。协变量包括年龄、性别、损伤严重程度评分-头部、保险类型、格拉斯哥昏迷量表评分和合并症。
结果
样本中共有 2487 名（86%）白人患者和 415 名（14%）黑人患者。共有 1513 名（52%）患者出院至住院康复治疗，1389 名（48%）患者出院至无服务的家中。在调整后的逻辑回归中，与白人相比，黑人更有可能出院至住院康复治疗而不是无服务的家中（优势比 1.34，95%置信区间 1.06-1.70）。
结论
在这群符合医疗保险资格的老年患者中，与白人相比，黑人更有可能出院至住院康复治疗。
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