School of Medicine, Keck Graduate Institute, Claremont, California, USA.
Department of Psychology, College of Health & Community Well-Being, University of La Verne, La Verne, California, USA.
PM R. 2022 Dec;14(12):1430-1438. doi: 10.1002/pmrj.12737. Epub 2022 Jan 5.
Persons of color have a higher incidence of traumatic brain injury (TBI) and experience disparities in the quality and quantity of interventions received, discharge disposition, functional outcomes, and mortality rate post TBI.
To examine racial/ethnic differences in rehabilitation outcomes for patients with TBI.
Multiyear (2005-2016) and retrospective cohort using secondary data analysis from inpatient rehabilitation facilities (IRFs) across the United States.
eRehabData participating IRFs throughout the United States.
Forty-one thousand eight hundred forty-seven adults with a diagnosis of TBI, admitted to U.S. eRehabData participating IRFs.
Not applicable.
Inpatient rehabilitation functional outcomes and discharge disposition.
Participants were 41,847 non-Hispanic Whites (NHWs), Hispanics, non-Hispanic Asians (NHAs), and non-Hispanic Blacks (NHBs) aged 18-107 years. NHWs were used as the reference group. NHBs had the longest length of stay (17.65 ± 14.96). At admission, NHB, Hispanic, and NHA races/ethnicities were significantly associated with 1-3 point lower motor, cognitive, and total Functional Independence Measure (FIM) scores. NHB race was significantly associated with less than 1-point lower cognitive, motor, and total efficiency FIM scores. At discharge, NHB race was significantly associated with 1-2 point lower motor, cognitive, and total FIM scores; Hispanics and NHA race were associated with less than 1-point lower cognitive FIM scores. Compared to NHWs, Hispanic ethnicity was associated with greater odds of a discharge to home (odds ratio = 1.16, 95% confidence interval = 1.06-1.27).
Contrary to established literature on functionality differences 1 year post TBI, the current study found racial/ethnic differences in functional outcomes during inpatient rehabilitation. These findings suggest a need for cultural competence/sensitivity in the care of racial/ethnic persons and centering potential contributing factors for racial/ethnic differences in TBI rehabilitation outcomes.
有色人种（指非裔美国人、拉丁裔或西班牙裔、亚洲人或太平洋岛民等）发生创伤性脑损伤（TBI）的比例更高，并且在接受干预的质量和数量、出院去向、功能结果以及 TBI 后的死亡率方面存在差异。
检查 TBI 患者康复结果的种族/民族差异。
使用来自美国各地住院康复设施（IRF）的二次数据分析进行多年（2005-2016 年）和回顾性队列研究。
美国参与 eRehabData 的 IRF。
41847 名患有 TBI 的成年人，入住美国 eRehabData 参与的 IRF。
无。
住院康复的功能结果和出院去向。
参与者是非西班牙裔白人（NHW）、西班牙裔、非西班牙裔亚洲人（NHA）和非西班牙裔黑人（NHB），年龄在 18-107 岁之间。NHW 用作参考组。NHB 的住院时间最长（17.65±14.96）。入院时，NHB、西班牙裔和 NHA 种族/民族与 1-3 分较低的运动、认知和总功能独立性测量（FIM）评分显著相关。NHB 种族与 1 分以下的认知、运动和总效率 FIM 评分显著相关。出院时，NHB 种族与 1-2 分较低的运动、认知和总 FIM 评分显著相关；西班牙裔和 NHA 种族与认知 FIM 评分较低相关。与 NHW 相比，西班牙裔民族与较高的出院回家几率相关（优势比=1.16，95%置信区间=1.06-1.27）。
与 TBI 后 1 年功能差异的既定文献相反，本研究在住院康复期间发现了功能结果的种族/民族差异。这些发现表明，在照顾种族/民族人群时需要具备文化能力/敏感性，并关注 TBI 康复结果中种族/民族差异的潜在促成因素。
