Examining the accuracy of the AM-PAC “6-clicks” at predicting discharge disposition in traumatic brain injury

Brett M. Tracy*, Melissa Victor, Randi N. Smith, Mark J. Hinrichs, Rondi B. Gelbard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: To assess the accuracy of the AM-PAC “6-Clicks” in predicting discharge dispositions among severely injured patients with an acute traumatic brain injury (TBI). Methods: We performed a retrospective review of patients with a TBI who presented to our trauma center from 2016 through 2018 and received a “6-Clicks” assessment. Outcomes were hospital length of stay (LOS) and discharge disposition: home, inpatient rehabilitation facility (IRF), subacute location (SL), or death/hospice. Subgroup analyses evaluated patients with concomitant mobility-limiting injuries (CM-LI). Results: There were 432 patients with a TBI; 42.6% (n = 184) had CM-LI. CM-LI patients had lower “6-Clicks” scores compared to patients with an isolated TBI (9 vs 14, p < .0001) and a longer hospital LOS (16.5 d vs 9 d, p < .0001). Increasing “6-Clicks” scores were associated with a home discharge (OR 1.21, 95% CI 1.15–1.28, p < .0001) while decreasing scores were predictive of an IRF or SL discharge or death/hospice. Increasing scores correlated with decreasing hospital LOS for the cohort (β − 8.93, 95% CI −10.24–−7.62, p < .0001). Conclusion: Among patients with an acute TBI, increasing “6 Clicks” scores were associated with a shorter hospital LOS and greater likelihood of home discharge. Decreasing mobility scores correlated with discharge to an IRF, SL, and death/hospice.

Original languageEnglish
Pages (from-to)52-58
Number of pages7
JournalBrain Injury
Issue number1
StatePublished - 2022
Externally publishedYes


  • Functional status
  • length of stay
  • postacute care
  • traumatic brain injury


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