Early rehabilitation intervention is associated with significant positive functional outcomes in traumatic brain injury: a retrospective analysis

Abstract

Background: Traumatic brain injury (TBI) is a global public health problem affecting adversely health care system. While acute trauma care has been documented to improve outcomes, the impact of early rehabilitation on outcome is not well documented especially in the developing world like ours. Predicting functional outcome from admission variables helps in intervention development, and appropriate fund allocation for TBI treatment. Therefore, we accepted a challenge to do a retrospective study on TBI patients admitted in our newly established and resource limited trauma center. The aim of the study was to assess the effect of early rehabilitation on TBI patients on functional improvement and to prognosticate the improvement from early admission variables.Methods: Study was conducted at Apex Trauma Center, SGPGIMS, Lucknow analysis of prospectively maintained data. Retrospective analysis of records of patients, admitted within 48 hrs of moderate to severe injury, was done after Institute Ethic Committee approval. Statistical analysis used was regression analysis and multivariate analysis was done between possible risk factors and FIM gain.Results: There was significant FIM score improvement from admission to discharge (p<0.001). Factors associated with a higher FIM gain were admission FIM motor and cognitive scores, GCS score on admission and length of hospital stay.Conclusions: Our study strongly suggests that a dedicated rehabilitation programme, designed according to the functional needs of TBI patient, helps in improved functional outcome and recovery.