0487 Polysomnography Associations with All-cause Hospitalization Following TBI Neurorehabilitation Discharge

Abstract Introduction Obstructive Sleep Apnea (OSA) is prevalent in neurorehabilitation admissions in patients with traumatic brain injury (TBI). OSA is independently associated with hospital readmission within 30 days of discharge in the general population. Prior studies showed rates of rehospitalizations in TBI patients are estimated at 28%. The most common rehospitalization causes are infection, neurologic issues, neurosurgical procedures, injury, psychiatric, and orthopedic. While older age, history of seizure, and greater physical and mental health comorbidities have been associated with rehospitalization following TBI, early objective measures of OSA have not been examined. Methods This is a retrospective analysis of TBI Model Systems (TBIMS) participants enrolled in a multicenter comparative effectiveness trial followed over the first two years post-discharge (n=175). Participants received level I polysomnography (PSG) during inpatient neurorehabilitation. Differences in PSG indices were examined by rehospitalization rates to determine associations. Mean age of 43.4 (SD 17.6), mostly of white ethnicity (74%). Multiple regression was used to examine rates of hospitalizations across PSG indices controlling for age. Results 102 patients (58%) had no hospitalization in the first 2 years of follow-up while 73 (42%) had at least 1 hospitalization (28 had 1 hospitalization, 45 had >1 hospitalization). While the apnea hypopnea index between the re-hospitalized (15.7) vs non-re-hospitalized (14.8) was not significantly different, the mean O2 nadir was 84.8% and 86.9%, respectively (r2=-2.49, p < 0.02, CI: -4.53, -0.45). Conclusion This is the first study looking at rehospitalization in patients with TBI and OSA, showing that re-hospitalized patients were more likely to have a worse O2 nadir warranting further exploration of PSG indices and the role of sleep apnea in rehospitalization following neurorehabilitation discharge after TBI. Support (if any) The research reported in this abstract was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award. The TBI Model Systems is a funded collaboration between the Department of Veterans Affairs and the Department of Health and Human Services: National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).