Research Reports - Functional outcomes in traumatic disorders of consciousness
Arch Phys Med Rehabil. 2013 May 31
Whyte J, Nakase-Richardson R, Hammond FM, McNamee S, Giacino JT, Kalmar K, Greenwald B, Yablon SA, Horn LJ.
OBJECTIVE: To characterize the 5-year outcomes of patients with traumatic brain
injury (TBI) not following commands when admitted to acute inpatient
rehabilitation. DESIGN: Retrospective analysis of prospectively-collected data
from the NIDRR-funded Traumatic Brain Injury Model System (TBIMS). SETTING:
Inpatient rehabilitation hospitals participating in the TBIMS program.
PARTICIPANTS: One hundred eight (108) patients with TBI not following commands at
admission to acute inpatient rehabilitation were divided into 2 groups (early
recovery: followed commands prior to discharge; n = 72; late recovery: did not
follow commands prior to discharge; n = 36). INTERVENTIONS: N/A MAIN OUTCOME
MEASURES: Functional Independence Measure items. RESULTS: For the early recovery
group, depending on the FIM item, 8% - 21% of patients were functioning
independently at discharge, increasing to 56% to 85% by 5-years post-injury. The
proportion functioning independently increased from discharge to 1 year, 1 to 2
years and 2 - 5 years. In the late recovery group, depending on the FIM item, 19
- 36% of patients were functioning independently. The proportion of independent
patients increased significantly from discharge to 1 year and from 1 to 2 years,
but not from 2 to 5 years. CONCLUSIONS: Substantial proportions of patients
admitted to acute inpatient rehabilitation prior to following commands recover
independent functioning over as long as 5 years, particularly if they begin to
follow commands prior to hospital discharge.