Hospital Readmission After Traumatic Brain Injury Hospitalization in Community‐Dwelling Older Adults

ABSTRACT Objective To examine the risk of hospital readmission after an index hospitalization for TBI in older adults. Methods Using data from the Atherosclerosis Risk in Communities (ARIC) study, we used propensity score matching of individuals with an index TBI‐related hospitalization to individuals with (1) non‐TBI hospitalizations (primary analysis) and (2) orthopedic injury hospitalizations (secondary analysis). The rate of all‐cause hospital readmission was estimated using adjusted Fine‐Gray proportional hazards regression models within strata defined by time since hospitalization. Follow‐up extended from the date of index hospitalization after study enrollment (1987–1989) through December 31, 2019. Results Six hundred sixty‐seven participants with an index TBI‐related hospitalization were matched using propensity scores with replacement with a ratio of 1:4–2668 participants with non‐TBI‐related hospitalizations and 1:3 with 2001 participants with orthopedic injury‐related hospitalizations. Median age was 68 years (IQR = 46–95) at index hospitalization. Compared to participants with an index non‐TBI‐related hospitalization, readmission rates were lower among participants with an index TBI‐related hospitalization (HR = 0.80, 95% CI = 0.74, 0.87) over a median follow‐up of 2.7 years, although similar readmission rates were observed within the first year of follow‐up (HR = 1.03, 95% CI = 0.88, 1.21). Rates of hospital readmission among persons with an index TBI‐related hospitalization were similarly decreased compared with persons with an orthopedic injury‐related hospitalization (HR = 0.78, 95% CI = 0.72, 0.85) over a median follow‐up of 3.1 years. Interpretation Among community‐dwelling older adults with a TBI‐related hospitalization, rates of hospital readmission were similar to individuals hospitalized for a non‐TBI cause in the first year, but lower subsequently. Targeted interventions in the first year post‐hospitalization may be most beneficial for reducing readmissions among individuals with TBI.