Research Reports - Cognitive activity limitations one year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury

J Rehabil Med. 2013 Sep 3;45(8):778-84

Sommer JB, Norup A, Poulsen I, Morgensen J

Objective: To examine cognitive activity limitations and predictors of outcome 1
year post-trauma in patients admitted to sub-acute rehabilitation after severe
traumatic brain injury. Subjects: The study included 119 patients with severe
traumatic brain injury admitted to centralized sub-acute rehabilitation in the
Eastern part of Denmark during a 5-year period from 2005 to 2009. Methods: Level
of consciousness was assessed consecutively during rehabilitation and at 1 year
post-trauma. Severity of traumatic brain injury was classified according to
duration of post-traumatic amnesia. The cognitive subscale of Functional
Independence MeasureTM (Cog-FIM) was used to assess cognitive activity
limitations. Multivariate logistic regression analyses were performed to identify
predictors of an independent level of functioning. Results: The majority of
patients progressed to a post-confusional level of consciousness during the first
year post-trauma. At follow-up 33-58% of patients had achieved functional
independence within the cognitive domains on the Cog-FIM. Socio-economic status,
duration of acute care and post-traumatic amnesia were significant predictors of
outcome. Conclusion: Substantial recovery was documented among patients with
severe traumatic brain injury during the first year post-trauma. The results of
the current study suggest that absence of consciousness at discharge from acute
care should not preclude patients from being referred to specialized sub-acute
rehabilitation.

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