Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study.
Arch Phys Med Rehabil
; 101(9): 1523-1531, 2020 09.
Article
en En
| MEDLINE
| ID: mdl-32544398
OBJECTIVES: To understand how health status preceding traumatic brain injury (TBI) affects relative functional gain after inpatient rehabilitation using a data mining approach. DESIGN: Population-based, sex-stratified, retrospective cohort study using health administrative data from Ontario, Canada (39% of the Canadian population). SETTING: Inpatient rehabilitation. PARTICIPANTS: Patients 14 years or older (N=5802; 63.4% male) admitted to inpatient rehabilitation within 1 year of a TBI-related acute care discharge between April 1, 2008, and March 31, 2015. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Relative functional gain (RFG) in percentage, calculated as ([discharge FIM-admission FIM]/[126-admission FIM]×100). Health status prior to TBI was identified and internally validated using a data mining approach that categorized all International Classification of Diseases, 10th revision, codes for each patient. RESULTS: The average RFG was 52.8%±27.6% among male patients and 51.6%±27.1% among female patients. Sex-specific Bonferroni adjusted multivariable linear regressions identified 10 factors of preinjury health status related to neurology, emergency medicine, cardiology, psychiatry, geriatrics, and gastroenterology that were significantly associated with reduced RFG in FIM for male patients. Only 1 preinjury health status category, geriatrics, was significantly associated with RFG in female patients. CONCLUSIONS: Comorbid health conditions present up to 5 years preceding the TBI event were significantly associated with RFG. These findings should be considered when planning and executing interventions to maximize functional gain and to support an interdisciplinary approach. Best practices guidelines and clinical interventions for older male and female patients with TBI should be developed given the increasingly aging population with TBI.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Centros de Rehabilitación
/
Estado de Salud
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Recuperación de la Función
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Minería de Datos
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Lesiones Traumáticas del Encéfalo
Tipo de estudio:
Guideline
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Observational_studies
/
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
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Patient_preference
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Arch Phys Med Rehabil
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Estados Unidos