NeuroRehabilitation · 2016
Predictors of improved functional outcome following inpatient rehabilitation for patients with traumatic brain injury.
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McLafferty Fred S, Barmparas Galinos, Ortega Alicia, Roberts Pamela, Ko Ara, Harada Megan, Nuño Miriam, Black Keith L, Ley Eric J
Аннотация
OBJECTIVE: To determine factors associated with response to inpatient rehabilitation treatment among TBI patients.
SETTING: Inpatient rehabilitation service at a Level I trauma center.
PARTICIPANTS: Moderate-severe TBI patients ages ≥ 18years old admitted between January 1, 2002 and December 31, 2012.
MAIN MEASURES: Response to inpatient rehabilitation, measured by the Functional Independence Measure (FIM) score.
DESIGN: Retrospective cohort study.
RESULTS: Of 1,984 patients treated for TBI, 184 (10.8%) underwent inpatient rehabilitation. The largest proportion of patients improved in mobility (98.9%), followed by self-care (93.7%), communication/social cognition (84.0%), and sphincter control (65.7%). Of these, 99 (53.8%) improved by 2 or more levels of functional independence and were considered rehabilitation responders. Responders were younger (53.1 years vs. 63.8, p < 0.01), had longer average rehabilitation stays (15.4 days vs. 12.2, p < 0.01), and were less likely to have an admission SBP <100 mmHg (7.1% vs. 17.1%, p = 0.01). On multivariate analysis, normotension at admission (AOR 0.06, p = 0.01) and longer rehabilitation LOS (AOR 1.11, p < 0.01) were associated with a response to inpatient rehabilitation.
CONCLUSION: Of the TBI patients who qualified for same-center inpatient rehabilitation, approximately half responded to treatment. Longer rehabilitation time and normotension at admission predicted response to rehabilitation. Further efforts are necessary to identify and optimize TBI patients for inpatient rehabilitation.
SETTING: Inpatient rehabilitation service at a Level I trauma center.
PARTICIPANTS: Moderate-severe TBI patients ages ≥ 18years old admitted between January 1, 2002 and December 31, 2012.
MAIN MEASURES: Response to inpatient rehabilitation, measured by the Functional Independence Measure (FIM) score.
DESIGN: Retrospective cohort study.
RESULTS: Of 1,984 patients treated for TBI, 184 (10.8%) underwent inpatient rehabilitation. The largest proportion of patients improved in mobility (98.9%), followed by self-care (93.7%), communication/social cognition (84.0%), and sphincter control (65.7%). Of these, 99 (53.8%) improved by 2 or more levels of functional independence and were considered rehabilitation responders. Responders were younger (53.1 years vs. 63.8, p < 0.01), had longer average rehabilitation stays (15.4 days vs. 12.2, p < 0.01), and were less likely to have an admission SBP <100 mmHg (7.1% vs. 17.1%, p = 0.01). On multivariate analysis, normotension at admission (AOR 0.06, p = 0.01) and longer rehabilitation LOS (AOR 1.11, p < 0.01) were associated with a response to inpatient rehabilitation.
CONCLUSION: Of the TBI patients who qualified for same-center inpatient rehabilitation, approximately half responded to treatment. Longer rehabilitation time and normotension at admission predicted response to rehabilitation. Further efforts are necessary to identify and optimize TBI patients for inpatient rehabilitation.
Предметные рубрики MeSH
AdultAge FactorsAgedAged, 80 and overBlood PressureBrain Injuries, TraumaticCohort StudiesCommunicationFemaleGlasgow Coma ScaleHumansInpatientsLength of StayMaleMiddle AgedMobility LimitationPredictive Value of TestsPrognosisRetrospective StudiesSelf CareSocial BehaviorTrauma CentersTreatment Outcome