A systematic review of comorbidity measurement methods for patients with non-traumatic brain injury in inpatient rehabilitation settings

摘要

This review summarizes comorbidity measurements used on patients with non-traumatic brain injury (nTBI) in inpatient rehabilitation and describes findings on measurement validation and comorbidity profiles. MEDLINE and MEDLINE In-Process, EMBASE, PsycINFO, the Cochrane Database of Systematic Reviews, Health and Psychosocial Measurement Instruments were searched. Two reviewers screened results according to pre-defined inclusion and exclusion criteria. Population, statistical methods, comorbidity measurement, justification of its use, and results involving comorbidity were extracted using a standard table. Of 9476 articles retrieved, 16 were included. Comorbidity has been measured using various methods including: number and type within various classification systems, such as the International Disease Classification system, the Charlson Comorbidity Index, Centers for Medicare and Medicaid Services Comorbidity Tiers, Patient Comorbidity and Complexity Level values, and subsets of diagnoses within non-administrative data studies. No studies have assessed the predictive ability of the comorbidity measurements for inpatient rehabilitation outcomes in this population. As comorbidities are common among the nTBI population, the predictive validity of comorbidity measurements should be assessed to determine the most appropriate measure to predict or risk adjust rehabilitation outcomes, which has implications for the development of clinical guidelines and to inform health service research, planning, and delivery.