Evidence map›Paper›PMID 39374687›Full record

ArticleArchives of physical medicine and rehabilitation2025

Home, but Homebound After Traumatic Brain Injury: Risk Factors and Associations With Nursing Home Entry and Death.

Raj G Kumar, Mary Louise Pomeroy, Katherine A Ornstein, Shannon B Juengst, Amy K Wagner, Jennifer M Reckrey, Kirk Lercher, Laura E Dreer, Emily Evans, Nicola L de Souza and 1 more

Abstract read
In one paragraph

Article in Archives of physical medicine and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Raj G KumarDepartment of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: raj.kumar@mountsinai.org.
Mary Louise PomeroyCenter for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland.
Katherine A OrnsteinCenter for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland.
Shannon B JuengstBrain Injury Research Center, TIRR Memorial Hermann, Houston, Texas; Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, Texas.
Amy K WagnerDepartments of Physical Medicine & Rehabilitation and Neuroscience, Safar Center for Resuscitation Research, Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
Jennifer M ReckreyDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Kirk LercherDepartment of Physical Medicine and Rehabilitation, New Jersey Medical School, Kessler Institute for Rehabilitation, Rutgers University, West Orange, New Jersey.
Laura E DreerDepartments of Ophthalmology & Visual Sciences & Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama.
Emily EvansDepartment of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts.
Nicola L de SouzaDepartment of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York.
Kristen Dams-O'ConnorDepartment of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.

Funding

EPIDEMIOLOGY AND BIOSTATISTICS OF AGINGT32AG000247 · NIA · JOHNS HOPKINS UNIVERSITY · PI Karen J. Bandeen-Roche · 1996 to 2026
$13.2M
Health Services and Outcomes Research for Aging PopulationsT32AG066576 · NIA · JOHNS HOPKINS UNIVERSITY · PI CYNTHIA Melinda BOYD, Jennifer L. Wolff · 2020 to 2026
$3.8M
Home, but homebound: The impact of caregiving, financial, and community resources on the lives of individuals with dementiaR01AG060967 · NIA · JOHNS HOPKINS UNIVERSITY · PI ORNSTEIN, KATHERINE A · 2019 to 2023
$2.5M
Validating an Administrative Claims Based Case Definition for Traumatic Brain InjuryR00HD106060 · NICHD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KUMAR, RAJ GOPALAN · 2023 to 2025
$745k
Investigating Disparities in Home Health Access and Quality for Medicare Beneficiaries with Alzheimer's Disease and Related Dementias Following Recent Payment System RevisionsR03AG083354 · NIA · VISITING NURSE SERVICE OF NEW YORK · PI BURGDORF, JULIA · 2023 to 2023
$335k
Leveraging existing data resources to characterize health and clinical care among older adults with traumatic brain injuryK99HD106060 · NICHD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KUMAR, RAJ GOPALAN · 2021 to 2022
$260k
ACL HHS 90ARHF0008ACL HHS 90DPTB0009ACL HHS 90DPTB0025ACL HHS 90DPTB0028NIA NIH HHS R01 AG060967NIA NIH HHS R03 AG083354NIA NIH HHS T32 AG000247NIA NIH HHS T32 AG066576NICHD NIH HHS K99 HD106060NICHD NIH HHS R00 HD106060
6 · The paper itself

Abstract

objectiveTo examine risk factors associated with homeboundness 1-year after traumatic brain injury (TBI) and to explore associations between homebound status and risk of future mortality and nursing home entry.

designSecondary analysis of a longitudinal prospective cohort study.

settingTBI Model Systems centers.

participantsCommunity-dwelling TBI Model Systems participants (n=6595) who sustained moderate-to-severe TBI between 2006 and 2016, and resided in a private residence 1-year postinjury.

interventionsNot applicable.

main outcome measuresHomebound status (leaving home ≤1-2d per week), 5-year mortality, and 2- or 5-year nursing home entry.

resultsIn our sample, 14.2% of individuals were homebound 1-year postinjury, including 2% who never left home. Older age, having less than a bachelor's degree, Medicaid insurance, living in the Northeast or Midwest, dependence on others or special services for transportation, unemployment or retirement, and needing assistance for locomotion, bladder management, and social interactions at 1-year postinjury were associated with being homebound. After adjustment for potential confounders and an inverse probability weight for nonrandom attrition bias, being homebound was associated with a 1.69-times (95% confidence interval, 1.35-2.11) greater risk of 5-year mortality, and a nonsignificant but trending association with nursing home entry by 5 years postinjury (RR=1.90; 95% confidence interval, 0.94-3.87). Associations between homeboundness and mortality were consistent by age subgroup (±65y).

conclusionsThe negative long-term health outcomes among persons with TBI who rarely leave home warrants the need to re-evaluate home discharge as unequivocally positive. The identified risk factors for homebound status, and its associated negative long-term outcomes, should be considered when preparing patients and their families for discharge from acute and postacute rehabilitation care settings. Addressing modifiable risk factors for homeboundness, such as accessible public transportation options and home care to address mobility, could be targets for individual referrals and policy intervention.

Indexed as

Brain Injuries, TraumaticHomebound PersonsNursing HomesAdultAgedAge FactorsFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesRisk FactorsUnited StatesDischarge planningHomeboundHome dischargePost-acuteRehabilitationSocial isolationTraumatic brain injury

Identifiers

PMID39374687
PMCPMC11968243

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.