Postacute Rehabilitation May Reduce Rehospitalization, Emergency Room Visits

A brain injury is far from a simple mishap; it’s not like the broken arm that derails a ski trip to Aspen. Unlike a fracture or laceration that can be splinted, bandaged, or stitched and that heals over time, brain injury often coincides with long-term risk for future problems, such as substance abuse, seizures, neuroendocrine and sleep abnormalities, as well as additional brain injuries.

As such, brain injury is increasingly considered a chronic disease process, rather than a single injury event, where patients may return to hospitals or rehabilitation due to physical and/or behavioral complications that resurface.

Being aware of long-term deficits and symptom recurrence, the founders of Centre for Neuro Skills (CNS) developed an intensive multidisciplinary model of rehabilitation. Since 1980, CNS has helped many patients maintain a durable recovery by teaching life skills and focusing on independence post injury.

The rehospitalization rate for CNS patients is the focus of a poster presentation by Stefanie N. Howell, Ph.D., a neuroscientist and researcher at the CNS Dallas clinic, and the lead author of the poster. “The incidence and etiology of rehospitalizations following discharge from a post-acute rehabilitation facility: A long-term study,” was co-written by Giuliana Cumpa, Kevin Randle, and Grace S. Griesbach, Ph.D., CNS National Director of Clinical Research, and was presented at the 2021 National Neurotrauma Society Conference.

Dr. Howell and her colleagues based their findings on a study of 90 brain injury patients who participated in a full-time, comprehensive, post-acute rehabilitation program. They were interviewed by phone at least one year post-discharge and every two years thereafter. All subjects were admitted to the post-acute program for a minimum of four weeks.

In general, rehospitalization rates can be as high as 45%. But this study revealed that the rate of rehospitalization following post-acute rehabilitation is much lower than seen in literature reviews (at around 9%). Of those, the majority were rehospitalized due to psychiatric concerns, seizures, substance abuse rehab or cancer.

What does this mean for CNS patients? That intensive therapy is highly effective.

The conclusion supports CNS’ legacy of goal-oriented treatment: “Results suggest that, given access to a comprehensive, multidisciplinary rehabilitation program in the post-acute recovery period, patients with TBI may have better outcomes and, ultimately, fewer rehospitalizations.”

“The biggest take home is what we can do to set the patient up for success post-discharge,” Dr. Howell said. “By understanding why and how often patients are returning to hospitals, we can anticipate and plan for issues that may arise in the future. With proper discharge planning, patient/family education, setting up community resources and establishing referrals for specialized health care, we can ultimately establish prevention tactics for avoiding rehospitalization and emergency room visits long-term.”