Predictors of improved functional outcome following inpatient rehabilitation for patients with traumatic brain injury

Fred S. McLafferty, Galinos Barmparas, Alicia Ortega, Pamela Roberts, Ara Ko, Megan Harada, Miriam A Nuno, Keith L. Black, Eric J. Ley

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)423-430
Number of pages8
JournalNeuroRehabilitation
Volume39
Issue number3
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Keywords

  • Glasgow Coma Scale (GCS)
  • hypotension
  • inpatient rehabilitation
  • rehabilitation responder
  • Traumatic brain injury (TBI)

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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    McLafferty, F. S., Barmparas, G., Ortega, A., Roberts, P., Ko, A., Harada, M., Nuno, M. A., Black, K. L., & Ley, E. J. (2016). Predictors of improved functional outcome following inpatient rehabilitation for patients with traumatic brain injury. NeuroRehabilitation, 39(3), 423-430. https://doi.org/10.3233/NRE-161373