1020 - Initial AM-PAC Assessment Predicts Discharge Disposition Following Trauma Admission Following TBI, SCI, and Orthopedic Fractures

Objectives: Delays in discharge planning increase acute care length of stay following trauma exposures.  Objective functional assessments that can predict discharge disposition are needed. This study aimed to evaluate the initial combined basic mobility and daily activity sub-scores of the Activity Measure for Post-Acute Care (AM-PAC) assessment in predicting discharge disposition following trauma exposure.

Design: We conducted a retrospective cohort study of adult patients (aged 18 to 90 years) admitted to a trauma service following  TBI, SCI, or Orthopedic fractures between 2016 and 2025. Data was summarized using descriptive statistics and assessed for statistically significant differences using a two-sample t-test with unequal variances test and Logistic Regression modeling.

Results: Of 4,674 patients (mean age 59.8 y; 53% male; 48% black), 62% were discharged to home and 38% were discharge to a rehabilitation facility. The mean combined AM-PAC score at the time of initial functional assessment amongst patients discharged to home was statistically significantly higher than patients discharged to a rehabilitation facility (37 vs. 27, p< 0.001), including patients with TBI(n=1,015, mean 39 vs. 29, p< 0.001), SCI(n=633, mean 37 vs. 27, p< 0.001), or Orthopedic fractures(n=3,026, mean 37 vs. 27, p< 0.001). For every additional point on the combined AM-PAC score, the odds of being discharged to home relative to a rehabilitation facility was 1.17 (95% CI 1.15 – 1.18, p< 0.001) for the complete cohort, and 1.17 (95% CI 1.14 – 1.20, p< 0.001) for TBI, 1.22 (95% CI 1.18 – 1.26, p< 0.001) for SCI, and 1.15 (95% CI 1.13 – 1.16, p< 0.001) for Orthopedic fractures.

Conclusions: We found evidence that the initial combined AM-PAC basic mobility and daily activity score predicts discharge to home following major trauma, including TBI, SCI, and Orthopedic.