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We aimed to develop a prognostic model that could be used at admission to inpatient rehabilitation facilities to predict discharge disposition. The model could be used to provide the interdisciplinary team with information regarding aspects of patients' functioning and\/or their living situation that need particular attention during inpatient rehabilitation if institutionalization is to be avoided. The study population included 7219 patients with moderate-severe TBI in the Traumatic Brain Injury Model Systems (TBIMS) National Database enrolled from 2002\u20132012 who had not been institutionalized prior to injury. Based on institutionalization predictors in other populations, we hypothesized that among people who had lived at a private residence prior to injury, greater dependence in locomotion, bed-chair-wheelchair transfers, bladder and bowel continence, feeding, and comprehension at admission to inpatient rehabilitation programs would predict institutionalization at discharge. Logistic regression was used, with adjustment for demographic factors, proxy measures for TBI severity, and acute-care length-of-stay. C-statistic and predictiveness curves validated a five-variable model. Higher levels of independence in bladder management (adjusted odds ratio [OR], 0.88; 95% CI 0.83, 0.93), bed-chair-wheelchair transfers (OR, 0.81 [95% CI, 0.83\u20130.93]), and comprehension (OR, 0.78 [95% CI, 0.68, 0.89]) at admission were associated with lower risks of institutionalization on discharge. For every 10-year increment in age was associated with a 1.38 times higher risk for institutionalization (95% CI, 1.29, 1.48) and living alone was associated with a 2.34 times higher risk (95% CI, 1.86, 2.94). The c-statistic was 0.780. We conclude that this simple model can predict risk of institutionalization after inpatient rehabilitation for patients with TBI.<\/jats:p>","DOI":"10.1089\/neu.2014.3351","type":"journal-article","created":{"date-parts":[[2014,9,15]],"date-time":"2014-09-15T14:07:42Z","timestamp":1410790062000},"page":"280-286","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Predicting Institutionalization after Traumatic Brain Injury Inpatient Rehabilitation"],"prefix":"10.1177","volume":"32","author":[{"given":"Regina S.","family":"Eum","sequence":"first","affiliation":[{"name":"Pioneer Spine & Sports Physicians"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald T.","family":"Seel","sequence":"additional","affiliation":[{"name":"Crawford Research Institute","place":["Georgia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen W.","family":"Brown","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas K.","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Moss Rehab"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan D.","family":"Zasler","sequence":"additional","affiliation":[{"name":"Concussion Care Centre of Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliot J.","family":"Roth","sequence":"additional","affiliation":[{"name":"Northwestern Feinberg School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross D.","family":"Zafonte","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mel B.","family":"Glenn","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,2,15]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Faul M. 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