Thirty-day re-admission after traumatic brain injury: Results from MarketScan®

Objective: To estimate the national 30-day re-admission rate after traumatic brain injury (TBI) in insured patients under age 65 and to examine factors that predict re-admission. Methods: This study reviewed data on patients hospitalized with a primary diagnosis of TBI in the MarketScan (R) database from 2010-2012. Patients with substantial concurrent injury to non-head regions were excluded. This study identified all hospitalizations within 30 days after index discharge and compared characteristics of patients who were re-admitted vs those who were not. Results: This study identified 26 831 patients with a primary diagnosis of TBI who survived the index hospitalization. Overall, 6.6% of patients were re-admitted within 30 days. TBI was the most common primary diagnosis for re-admission (28.5%), followed by psychiatric disorders (12.5%). Patients who were older, had a head Abbreviated Injury Score of 3 or more, one or more comorbidities, longer length of stay or who were discharged to an inpatient rehabilitation facility demonstrated greater odds of being re-admitted within 30 days. Conclusions: Factors associated with re-admission after TBI should be considered in discharge planning. Further research is warranted to examine re-admission beyond 30 days and further elucidate causes of re-admission in order to develop strategies to reduce re-admission among patients with TBI.