Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges

Cowen, Todd D.; Meythaler, Jay M.; DeVivo, Michael J.; Ivie, Clarence S.; Lebow, Joan; Novack, Thomas A.

doi:10.1016/s0003-9993(95)80542-7

Cited by 125 publications

(40 citation statements)

References 11 publications

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“…Prevalence of male patients (78.5%) in this sample is in line with that reported in the European literature [3,14,15], contrary to some North American authors' data [11,13]. In the data Caucasians prevailed over other ethnic groups, contrary to the US experience [16].…”

Section: Discussionsupporting

confidence: 87%

“…The average age of the sample is in line with some US [11][12][13] and European data [3,14,15]. Prevalence of male patients (78.5%) in this sample is in line with that reported in the European literature [3,14,15], contrary to some North American authors' data [11,13].…”

Section: Discussionsupporting

confidence: 87%

“…The positive role of an early admission to a rehabilitation department is confirmed by the literature [4,11,20], hence the need for Italian Health Organizations to pay more attention to improving the transferal from the emergency department to the rehabilitation one.…”

Section: Discussionmentioning

confidence: 92%

See 2 more Smart Citations

Rehabilitation of traumatic brain injury in Italy: A multi-centred study

Zampolini¹,

Zaccaria

Tolli

et al. 2011

Brain Injury

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

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Rehabilitation of traumatic brain injury in Italy: A multi-centred study

Zampolini¹,

Zaccaria

Tolli

et al. 2011

Brain Injury

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“…Many previous studies have examined only the effects of patient and injury characteristics on outcomes. 1–7 The association of TBI rehabilitation outcomes with processes of care has not been studied comprehensively. Studies that have examined treatments have focused on specific rehabilitation techniques or aggregate time in physical (PT), occupational (OT), or speech (ST) therapy.…”

mentioning

confidence: 99%

Traumatic Brain Injury Patient, Injury, Therapy, and Ancillary Treatments Associated With Outcomes at Discharge and 9 Months Postdischarge

Horn

Corrigan

Beaulieu

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Objective To examine associations of patient and injury characteristics, inpatient rehabilitation therapy activities, and neurotropic medications with outcomes at discharge and 9 months post-discharge for patients with traumatic brain injury (TBI) Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Consecutive patients (n=2130) enrolled between 2008 and 2011, admitted for inpatient rehabilitation after an index TBI injury Interventions Not applicable Main Outcome Measures Rehabilitation length of stay, discharge to home, and Functional Independence Measure (FIM) at discharge and 9 months post-discharge Results The admission FIM Cognitive score was used to create 5 relatively homogeneous subgroups for subsequent analysis of treatment outcomes. Within each subgroup, significant associations were found between outcomes and patient and injury characteristics, time spent in therapy activities, and medications used. Patient and injury characteristics explained on average 35.7% of the variation in discharge outcomes and 22.3% in 9-month outcomes. Adding time spent and level of effort in therapy activities, as well as percent of stay using specific medications, explained approximately 20.0% more variation for discharge outcomes and 12.9% for 9-month outcomes. After patient, injury, and treatment characteristics were used to predict outcomes, center differences added only approximately 1.9% additional variance explained. Conclusions At discharge, greater effort during therapy sessions, time spent in more complex therapy activities, and use of specific medications were associated with better outcomes for patients in all admission FIM Cognitive subgroups. At 9 months post-discharge, similar but less pervasive associations were observed for therapy activities, but not classes of medications. Further research is warranted to examine more specific combinations of therapy activities and medications that are associated with better outcomes.

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“…The authors of a recent Cochrane review concluded that intensive intervention appears to lead to earlier gains 33. Earlier transfer to rehabilitation can improve functional outcome and lower both rehabilitation and acute hospitalisation costs 34. However, access to neurorehabilitation services remains restricted 11…”

Section: Why Is Rehabilitation Important After Tbi?mentioning

confidence: 99%

Traumatic brain injury in adults

et al. 2013

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Traumatic brain injury (TBI) remains a major public health problem. This review aims to present the principles upon which modern TBI management should be based. The early management phase aims to achieve haemodynamic stability, limit secondary insults (eg hypotension, hypoxia), obtain accurate neurological assessment and appropriately select patients for further investigation. Since 2003, the mainstay of risk stratification in the UK emergency departments has been a system of triage based on clinical assessment, which then dictates the need for a CT scan of the head. For patients with acute subdural or extradural haematomas, time from clinical deterioration to operation should be kept to a minimum, as it can affect their outcome. In addition, it is increasingly recognised that patients with severe and moderate TBI should be managed in neuroscience centres, regardless of the need for neurosurgical intervention. The monitoring and treatment of raised intracranial pressure is paramount for maintaining cerebral blood supply and oxygen delivery in patients with severe TBI. Decompressive craniectomy and therapeutic hypothermia are the subject of ongoing international multi-centre randomised trials. TBI is associated with a number of complications, some of which require specialist referral. Patients with post-concussion syndrome can be helped by supportive management in the context of a multi-disciplinary neurotrauma clinic and by patient support groups. Specialist neurorehabilitation after TBI is important for improving outcome.

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Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges

Cited by 125 publications

References 11 publications

Rehabilitation of traumatic brain injury in Italy: A multi-centred study

Rehabilitation of traumatic brain injury in Italy: A multi-centred study

Traumatic Brain Injury Patient, Injury, Therapy, and Ancillary Treatments Associated With Outcomes at Discharge and 9 Months Postdischarge

Traumatic brain injury in adults

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