Abstract 25: Aneurysmal Subarachnoid Hemorrhage and Traumatic Brain Injury: A Comparison of Rehabilitation Outcomes

Abstract

Objective: To compare short-term functional outcome in persons with diffuse brain injury of different etiologies, aneurysmal subarachnoid hemorrhage (SAH) versus traumatic brain injury (TBI). Design: Cohort study with matched group comparison. Setting: Acute inpatient interdisciplinary brain injury rehabilitation unit of a level I trauma center. Participants: Included a total of 48 patients with brain injury during the study period (2002–2004). 24 consecutive admissions with nontraumatic SAH were identified. A matched cohort of 24 patients with TBI were selected from 133 TBI admissions during this period on the basis of age, acute hospital length of stay (LOS), gender, and total admission FIM score. As intended by the design, the groups were found equal on all matching variables (all P>.05). Interventions: Not applicable. Main Outcome Measures: Total discharge FIM score, rehabilitation LOS (RLOS), FIM gain, and FIM efficiency defined as FIM gain/RLOS. Results: The TBI group had a shorter RLOS (18.7d vs 25.9d, P=.04) along with a greater FIM efficiency (2.17 vs 1.37, P=.01). The TBI group displayed better efficiency on both the FIM motor scale (1.83 vs 1.19, P=.01) and the FIM cognitive scale (.33 vs .17, P=.03). No between-group difference was found for either total discharge FIM or FIM gain (both, P>.05). Conclusions: This study demonstrated that a group of patients with TBI receiving inpatient rehabilitation made more rapid functional gains than a group of SAH patients matched for age, gender, acute LOS, and admission functional level. Rehabilitation programs should anticipate slower recoveries in aneurysmal SAH patients compared with TBI patients of similar prognostic markers.