Length of Stay as the Critical Predictor of Functional Improvement in Post-Acute Care for Traumatic Brain Injury: A...

ObjectivesTraumatic brain injury (TBI) is a leading cause of long-term disability. This study aimed to evaluate the effectiveness of a Post-Acute Care (PAC) program for patients with TBI in Taiwan and to identify the independent predictors associated with the magnitude of their functional recovery.MethodsThis retrospective cohort study included 168 patients with TBI admitted to a PAC program from a tertiary medical center. The primary outcome was the change score in the Barthel Index (BI)(ADL). The Wilcoxon Signed-Rank Test was used to assess changes in functional scores (BI(ADL), IADL, and EQ-5D) from admission to discharge.ResultsPatients demonstrated statistically significant improvements across all functional measures after the PAC intervention, including the BI(ADL), IADL, and EQ-5D (all p < .001). After adjusting for all covariates, length of stay was the sole significant independent predictor of the BI(ADL) change score (B = 0.309, p < .001), indicating that for each additional day of PAC, a patient's BI score was expected to improve by 0.309 points.ConclusionPost-Acute Care is a highly effective intervention for improving functional outcomes in patients with TBI. These findings provide a strong evidence base for clinicians to advocate for sufficient rehabilitation time and for policymakers.