Research Reports - Functional outcomes in traumatic disorders of consciousness: 5-year outcomes

Arch Phys Med Rehabil. 2013 Oct;94(10):1855-60

Whyte J, Nakase-Richardson R, Hammond FM, McNamee S, Giacino JT, Kalmar K, Greenwald BD, 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: Secondary analysis of prospectively collected data from the National
Institute on Disability and Rehabilitation Research-funded Traumatic Brain Injury
Model Systems (TBIMS).
SETTING: Inpatient rehabilitation hospitals participating in the TBIMS program.
PARTICIPANTS: Patients (N=108) with TBI not following commands at admission to
acute inpatient rehabilitation were divided into 2 groups (early recovery:
followed commands before discharge [n=72]; late recovery: did not follow commands
before discharge [n=36]).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: FIM items.
RESULTS: For the early recovery group, depending on the FIM item, 8% to 21% of
patients were functioning independently at discharge, increasing to 56% to 85% by
5 years postinjury. The proportion functioning independently increased from
discharge to 1 year, 1 to 2 years, and 2 to 5 years. In the late recovery group,
depending on the FIM item, 19% to 36% of patients were functioning independently
by 5 years postinjury. 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 before following commands recover independent functioning over as
long as 5 years, particularly if they begin to follow commands before hospital
discharge.

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