Abstract
Primary objective: To evaluate the association of demographic factors, post-traumatic amnesia (PTA) and a standardized measure of ability limitations with clinical decisions for Next Level of Care following acute hospital treatment for moderate-severe traumatic brain injury (TBI). Research design: A TBI Clinical Nurse specialist recorded PTA for 212 individuals and rated 159 on the Ability and Adjustment Indices of the Mayo-Portland Adaptability Inventory (MPAI-4) for comparison with clinical decisions. Main outcomes and results: Multivariate logistic regression analyses revealed that independent ratings on the MPAI-4 Ability Index and PTA were associated with the clinical decision to admit to Inpatient Rehabilitation vs discharge to Home in 92.7% of the sample; ratings on the Ability Index alone were associated with this decision in 92.2% of cases. Age over 65 was the only variable associated with discharge to a Skilled Nursing Facility, correctly predicting this decision in 64% of cases. Conclusions: Use of a standardized measure of ability limitations appears feasible to provide supportive documentation and potentially improve the consistency of decision-making in recommending Inpatient Rehabilitation vs discharge to Home. Although age is a significant factor in the decision to discharge to a Skilled Nursing Facility, this decision appears complex and merits further study.
Original language | English (US) |
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Pages (from-to) | 22-29 |
Number of pages | 8 |
Journal | Brain Injury |
Volume | 23 |
Issue number | 1 |
DOIs | |
State | Published - 2009 |
Keywords
- Brain Injury
- Medical decision-making
- Rehabilitation
ASJC Scopus subject areas
- Neuroscience (miscellaneous)
- Developmental and Educational Psychology
- Clinical Neurology