WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Settings
2.2. WHODAS 2.0 Assessment
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Community-Dwelling n = 4895 | Institutionalized n = 3735 | p-Value | ||
---|---|---|---|---|---|
n | % | n | % | ||
Gender | 0.0010 | ||||
Male | 3281 | 67.03 | 2628 | 70.36 | |
Female | 1614 | 32.94 | 1107 | 29.64 | |
Age (years) | <0.001 | ||||
18–49 | 1500 | 30.64 | 773 | 20.70 | |
50–64 | 1381 | 28.21 | 1094 | 29.29 | |
65–74 | 890 | 18.18 | 840 | 22.49 | |
≥75 | 1124 | 22.96 | 1028 | 27.52 | |
Total (mean, SD) | 58.51 | 18.54 | 62.49 | 16.91 | |
Work Status | <0.001 | ||||
Employed | 211 | 4.31 | 28 | 0.75 | |
Unemployed | 4684 | 95.69 | 3707 | 99.25 | |
Education | <0.001 | ||||
≥College | 122 | 2.49 | 82 | 2.20 | |
Senior high | 606 | 12.38 | 470 | 12.58 | |
Junior high | 1963 | 40.10 | 1236 | 33.09 | |
≤Primary | 1834 | 37.47 | 1563 | 41.85 | |
No education | 370 | 7.56 | 384 | 10.28 | |
Family Income Status | <0.001 | ||||
Average | 4797 | 98.00 | 3542 | 94.83 | |
Middle–low and low | 98 | 2.00 | 193 | 5.17 | |
Urbanization Level | 0.0116 | ||||
Rural | 794 | 16.22 | 592 | 15.85 | |
Suburban | 2137 | 43.66 | 1528 | 40.91 | |
Urban | 1964 | 40.12 | 1615 | 43.24 | |
Severity of Impairment | <0.001 | ||||
Mild | 1321 | 36.99 | 190 | 5.09 | |
Moderate | 1632 | 33.34 | 596 | 15.96 | |
Severe | 1042 | 21.29 | 1005 | 26.91 | |
Extreme | 900 | 18.39 | 1944 | 52.05 | |
Cognition (n, mean ± SD) a | |||||
1-1 | 4866 | 2.08 ± 1.49 | 3715 | 3.31 ± 1.12 | <0.001 |
1-2 | 4830 | 2.16 ± 1.42 | 3687 | 3.30 ± 1.12 | <0.001 |
1-3 | 4838 | 2.35 ± 1.46 | 3702 | 3.45 ± 1.04 | <0.001 |
1-4 | 4356 | 2.60 ± 1.36 | 3511 | 3.52 ± 0.92 | <0.001 |
1-5 | 4891 | 1.70 ± 1.47 | 3733 | 3.05 ± 1.29 | <0.001 |
1-6 | 4876 | 2.02 ± 1.54 | 3725 | 3.31 ± 1.16 | <0.001 |
Mobility (n, mean ± SD) a | |||||
2-1 | 4831 | 2.52 ± 1.45 | 3712 | 3.60 ± 0.86 | <0.001 |
2-2 | 4893 | 1.80 ± 1.57 | 3732 | 3.35 ± 1.11 | <0.001 |
2-3 | 4886 | 1.62 ± 1.50 | 3590 | 2.98 ± 1.42 | <0.001 |
2-4 | 4882 | 1.87 ± 1.50 | 3572 | 3.11 ± 1.34 | <0.001 |
2-5 | 4745 | 2.67 ± 1.41 | 3662 | 3.63 ± 0.88 | <0.001 |
WHODAS 2.0 (n, mean ± SD) b | |||||
Cognition (Domain 1) | 4895 | 56.52 ± 33.01 | 3735 | 84.68 ± 24.43 | <0.001 |
Mobility (Domain 2) | 4895 | 56.62 ± 33.09 | 3735 | 85.79 ± 22.46 | <0.001 |
Self-care (Domain 3) | 4895 | 39.00 ± 34.39 | 3735 | 60.65 ± 38.13 | <0.001 |
Getting along (Domain 4) | 4895 | 63.28 ± 33.29 | 3735 | 88.52 ± 22.13 | <0.001 |
Life activities (Domain 5-1) | 4895 | 70.91 ± 36.92 | 3735 | 89.48 ± 28.03 | <0.001 |
Social participation (Domain 6) | 4895 | 53.37 ± 26.72 | 3735 | 72.44 ± 25.05 | <0.001 |
Summary | 4895 | 56.26 ± 25.79 | 3735 | 80.09 ± 18.79 | <0.001 |
Domain | Cut-Off Point | Sensitivity (%) | Specificity (%) | Youden’s Index | AUC (95% CI) |
---|---|---|---|---|---|
Cognition | 77.50 | 75.2 | 66.1 | 0.413 | 0.754 (0.744–0.765) |
Mobility | 78.13 | 76.0 | 66.2 | 0.422 | 0.767 (0.757–0.777) |
Self-care | 65.00 | 52.2 | 75.9 | 0.281 | 0.660 (0.648–0.672) |
Getting along | 87.50 | 76.5 | 64.6 | 0.411 | 0.742 (0.731–0.752) |
Life activities | 95.00 | 80.9 | 52.5 | 0.333 | 0.667 (0.656–0.679) |
Social participation | 60.42 | 69.2 | 61.4 | 0.307 | 0.701 (0.690–0.712) |
Summary | 66.85 | 79.6 | 63.1 | 0.427 | 0.769 (0.759–0.779) |
Variables | Univariate Model | Multivariate Model 1 | Multivariate Model 2 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
β | SE | Odds Ratio (OR) (95% CI) | p-Value | β | SE | OR (adjusted) (95% CI) | p-Value | β | SE | OR (adjusted) (95% CI) | p-Value | |
Gender (reference = male) | ||||||||||||
Female | −0.16 | 0.047 | 0.86 (0.78–0.94) | 0.0010 | −0.25 | 0.054 | 0.78 (0.70–0.87) | <0.001 | −0.22 | 0.056 | 0.80 (0.72–0.89) | <0.001 |
Age (ref. = 18–49) | ||||||||||||
50–64 | 0.43 | 0.060 | 1.54 (1.37–1.73) | <0.001 | 0.43 | 0.069 | 1.54 (1.35–1.76) | <0.001 | 0.38 | 0.073 | 1.46 (1.27–1.68) | <0.001 |
65–74 | 0.61 | 0.065 | 1.83 (1.61–2.08) | <0.001 | 0.52 | 0.093 | 1.68 (1.40–2.01) | <0.001 | 0.41 | 0.098 | 1.50 (1.24–1.82) | <0.001 |
≥75 | 0.57 | 0.062 | 1.78 (1.57–2.00) | <0.001 | 0.40 | 0.092 | 1.49 (1.25–1.79) | <0.001 | 0.20 | 0.096 | 1.23 (1.02–1.48) | 0.0337 |
Work Status (reference = employment) | ||||||||||||
Unemployed | 1.79 | 0.202 | 5.96 (4.01–8.87) | <0.001 | 1.01 | 0.221 | 2.73 (1.77–4.22) | <0.001 | 0.76 | 0.239 | 2.15 (1.35–3.43) | 0.0014 |
Education (reference = ≥college) | ||||||||||||
Senior high | 0.14 | 0.156 | 1.15 (0.85–1.57) | 0.3572 | 0.23 | 0.175 | 1.26 (0.89–1.77) | 0.1935 | 0.18 | 0.183 | 1.19 (0.83–1.71) | 0.3335 |
Junior high | −0.07 | 0.147 | 0.94 (0.70–1.25) | 0.6577 | 0.14 | 0.166 | 1.15 (0.83–1.59) | 0.4025 | 0.18 | 0.174 | 1.20 (0.85–1.68) | 0.3015 |
≤Primary | 0.24 | 0.147 | 1.27 (0.95–1.69) | 0.1060 | 0.12 | 0.171 | 1.13 (0.81–1.58) | 0.4667 | 0.11 | 0.178 | 1.12 (0.79–1.59) | 0.5262 |
Illiterate | 0.43 | 0.160 | 1.54 (1.13–2.11) | 0.0067 | 0.23 | 0.187 | 1.25 (0.87–1.81) | 0.2279 | 0.23 | 0.195 | 1.26 (0.86–1.85) | 0.2362 |
Family Income (reference = average) | ||||||||||||
Middle–low and low | 0.98 | 0.126 | 2.67 (2.08–3.41) | <0.001 | 0.81 | 0.139 | 2.24 (1.70–2.94) | <0.001 | 0.79 | 0.144 | 2.20 (1.66–2.92) | <0.001 |
Urbanization level (reference = urban) | ||||||||||||
Rural | −0.10 | 0.064 | 0.91 (0.80–1.03) | 0.1251 | −0.16 | 0.072 | 0.85 (0.74–0.98) | 0.0251 | −0.11 | 0.075 | 0.90 (0.78–1.04) | 0.1564 |
Suburban | −0.14 | 0.047 | 0.87 (0.79–0.95) | 0.0032 | −0.18 | 0.053 | 0.84 (0.76–0.93) | <0.001 | −0.18 | 0.056 | 0.83 (0.75–0.93) | 0.0010 |
Severity of impairment (reference = mild) | ||||||||||||
Moderate | 0.93 | 0.091 | 2.54 (2.12–3.04) | <0.001 | 0.85 | 0.092 | 2.34 (1.95–0.80) | <0.001 | 0.60 | 0.097 | 1.81 (1.50–2.19) | <0.001 |
Severe | 1.90 | 0.089 | 6.71 (5.63–7.99) | <0.001 | 1.79 | 0.091 | 6.02 (5.04–7.19) | <0.001 | 1.13 | 0.097 | 3.09 (2.55–3.74) | <0.001 |
Extreme | 2.71 | 0.087 | 15.02(12.65–17.83) | <0.001 | 2.61 | 0.089 | 13.63 (11.45–16.21) | <0.001 | 1.52 | 0.100 | 4.58 (3.76–5.57) | <0.001 |
Domain Score b | ||||||||||||
Cognition | 1.78 | 0.048 | 5.90 (5.37–6.49) | <0.001 | 0.34 | 0.079 | 1.40 (1.20–1.63) | <0.001 | ||||
Mobility | 1.82 | 0.049 | 6.19 (5.62–6.81) | <0.001 | 0.72 | 0.070 | 2.06 (1.80–2.36) | <0.001 | ||||
Self-care | 1.24 | 0.047 | 3.44 (3.14–3.77) | <0.001 | −0.02 | 0.063 | 0.98 (0.87–1.11) | 0.7712 | ||||
Getting along | 1.78 | 0.049 | 5.94 (5.40–6.53) | <0.001 | 0.34 | 0.079 | 1.40 (1.20–1.64) | <0.001 | ||||
Life activities | 1.54 | 0.051 | 4.67 (4.23–5.16) | <0.001 | 0.39 | 0.065 | 1.48 (1.31–1.68) | <0.001 | ||||
Social participation | 1.28 | 0.046 | 3.59 (3.28–3.92) | <0.001 | 0.27 | 0.061 | 1.31 (1.16–1.48) | <0.001 |
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Huang, S.-W.; Chang, K.-H.; Escorpizo, R.; Chang, F.-H.; Liou, T.-H. WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury. Int. J. Environ. Res. Public Health 2019, 16, 1484. https://doi.org/10.3390/ijerph16091484
Huang S-W, Chang K-H, Escorpizo R, Chang F-H, Liou T-H. WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury. International Journal of Environmental Research and Public Health. 2019; 16(9):1484. https://doi.org/10.3390/ijerph16091484
Chicago/Turabian StyleHuang, Shih-Wei, Kwang-Hwa Chang, Reuben Escorpizo, Feng-Hang Chang, and Tsan-Hon Liou. 2019. "WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury" International Journal of Environmental Research and Public Health 16, no. 9: 1484. https://doi.org/10.3390/ijerph16091484