Presence of a dedicated trauma center physiatrist improves functional outcomes following traumatic brain injury

Greiss, Christine; Yonclas, Peter; Jasey, Neil; Lequerica, Anthony; Ward, Irene; Chiaravalloti, Nancy D.; Félix, Gabriel M. F.; Dabaghian, Laurie; Livingston, David H.

doi:10.1097/ta.0000000000000890

Cited by 24 publications

(23 citation statements)

References 12 publications

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“…While values reported elsewhere vary for numerous reasons including study interventions and injury characteristics, our values are similar to those of others who report FIM total score change between 14 and 40 [15,39,44,45]. The greater improvement in FIM total score for individuals who arrived to rehabilitation from acute care may be a result of these individuals experiencing inpatient rehabilitation closer to the date of injury, and most recovery occurs in the weeks and months after injury and tapers off as time progresses [46].…”

Section: Change In Fim Score From Admission To Discharge From Rehabilsupporting

confidence: 71%

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome

2017

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Objectives-1) To describe trends in time to rehabilitation admission and rehabilitation length of stay (LOS), and functional status, 2) To identify independent predictors of functional outcomes following rehabilitation.Design-Retrospective cohort study. Methods-We collected information on time from injury to rehabilitation admission, rehabilitation LOS, Functional Independence Measure (FIM) score (admission and discharge), and demographic variables by chart review. Hierarchical regression was employed to investigate variables associated with FIM score at rehabilitation discharge. Setting-TraumaticResults-Data from 208 patients were obtained. Mean time from injury to rehabilitation admission was 263±274 days. Rehabilitation LOS was 66±43 days. FIM scores improved significantly during rehabilitation. After controlling for other variables, increasing time from

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Section: Change In Fim Score From Admission To Discharge From Rehabilsupporting

confidence: 71%

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome

2017

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“…Early rehabilitation medicine specialist care and consultation during the acute hospitalisation of patients with traumatic brain injury (TBI) have been shown to be associated with better functional outcomes and shorter length of stay (LOS). 1,2 Earlier rehabilitation admission was associated with greater recovery, lower costs and shorter LOS in severe TBI patients. [3][4][5] Early initiation of rehabilitation within an acute setting followed by direct transfer to a specialised rehabilitation hospital (continuous chain of early rehabilitation) has also shown a decrease in disability and increase in cost-effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Demographics of traumatic brain injury and outcomes of continuous chain of early rehabilitation in Singapore

Lui

Fook‐Chong

Teo

2020

Proceedings of Singapore Healthcare

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Background: Evidence shows that early initiation of a continuous chain of rehabilitation is associated with better functional outcomes in traumatic brain injured patients. The Department of Rehabilitation Medicine initiated early screening and review of patients with all traumatic brain injury (TBI) severity within 72 hours of acute admission, followed by direct transfer of suitable patients to acute inpatient rehabilitation (AIR). Objectives: This study aim to document the demographics and clinical characteristics of all TBI patients admitted to the local acute hospital; determine the characteristics of patients with TBI who are directly transferred to AIR following early screening and review; and determine clinical predictors affecting functional outcomes of patients of all TBI severity. Methods: A total of 491 patients were screened and reviewed; 116 patients were directly transferred to AIR. Results: The median age of the screened cohort was 67.0 years (interquartile range 50.0–77.0 years). Falls were the leading mechanism of TBI. Infection (odds ratio (OR)=2.95, 95% confidence interval (CI) 1.59–5.49) and neurosurgical intervention (OR=2.18, 95% CI 1.24–3.81) increased the odds of transfer to AIR. The Functional Independence Measure (FIM) gain after receiving AIR was significant ( p<0.001). Increased age, complications, high motor admission FIM (AFIM) and long rehabilitation length of stay (RLOS) were negatively associated with FIM gain and FIM efficiency. Conclusions: Our study demonstrated that falls were the leading mechanism of TBI, with the majority of patients being older. Infection and neurosurgical intervention increased the likelihood of transfer to AIR. There was functional improvement after AIR. Age, complications, motor AFIM and RLOS were negatively associated with FIM gain and FIM efficiency. Further local research is warranted to confirm these findings.

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“…17,39,65 In addition, difficulties to generalizability were seen in studies with specific foci, having limited sample sizes available that satisfied their inclusion criteria. 14,18,20,23,27,28,[32][33][34]38,40,50,53,55,[57][58][59][60][61][62]64,[66][67][68][69][70][71] Thirty of 74 articles (41%) reported their limited ability to generalize to the overall TBI population, including those under-represented in the TBIMS data sets due to loss of follow-up or by database collection methods. Other factors impacting generalizability include sample size and missing data, which is a limitation in itself.…”

Section: Resultsmentioning

confidence: 99%

The Traumatic Brain Injury Model Systems National Database: A Review of Published Research

Tso

Saha

Cusimano

2021

Neurotrauma Reports

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The Traumatic Brain Injury Model Systems (TBIMS) is the largest longitudinal TBI data set in the world. Our study reviews the works using TBIMS data for analysis in the last 5 years. A search (2015-2020) was conducted across PubMed, EMBASE, and Google Scholar for studies that used the National Institute on Disability, Independent Living and Rehabilitation Research NIDILRR/VA-TBIMS data. Search terms were as follows: [''TBIMS'' national database] within PubMed and Google Scholar, and [''TBIMS' ' AND national AND database] on EMBASE. Data sources, study foci (in terms of data processing and outcomes), study outcomes, and follow-up information usage were collected to categorize the studies included in this review. Variable usage in terms of TBIMS' form-based variable groups and limitations from each study were also noted. Assessment was made on how TBIMS' objectives were met by the studies. Of the 74 articles reviewed, 23 used TBIMS along with other data sets. Fifty-four studies focused on specific outcome measures only, 6 assessed data aspects as a major focus, and 13 explored both. Sample sizes of the included studies ranged from 11 to 15,835. Forty-two of the 60 longitudinal studies assessed follow-up from 1 to 5 years, and 15 studies used 10 to 25 years of the same. Prominent variable groups as outcome measures were ''Employment,'' ''FIM,'' ''DRS,'' ''PART-O,'' ''Satisfaction with Life,'' ''PHQ-9,'' and ''GOS-E.'' Limited numbers of studies were published regarding tobacco consumption, the Brief Test of Adult Cognition by Telephone (BTACT), the Supervision Rating Scale (SRS), general health, and comorbidities as variables of interest. Generalizability was the most significant limitation mentioned by the studies. The TBIMS is a rich resource for large-sample longitudinal analyses of various TBI outcomes. Future efforts should focus on under-utilized variables and improving generalizability by validation of results across large-scale TBI data sets to better understand the heterogeneity of TBI.

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Presence of a dedicated trauma center physiatrist improves functional outcomes following traumatic brain injury

Abstract: Therapeutic study, level IV.

Cited by 24 publications

References 12 publications

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome

Demographics of traumatic brain injury and outcomes of continuous chain of early rehabilitation in Singapore

The Traumatic Brain Injury Model Systems National Database: A Review of Published Research

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