Functional outcome after violence related traumatic brain injury

Abstract

Violent injuries have become an increasingly prevalent cause of traumatic brain injury TBI. These injuries can be classified as either penetrating or non penetrating in nature. While much of the research on violence has been within a military population, there exists a marked difference between military and civilian injuries. Prior work has reported relatively poor outcomes for those individuals who have suffered penetrating TBIs, but little has been done to assess specific functional outcome parameters in survivors. We examined 25 subjects that had sustained blunt injuries and 25 cases with penetrating injuries as a result of a violent act. Cases were matched by initial Glasgow Coma Scale GCS, age and educational level. Mean GCS for this study sample was 8.8. The following outcome variables were assessed at rehabilitation admission and discharge and at 1 year post injury: Disability Rating Scale DRS, Rancho Los Amigos Scale LCFS, Functional Independence Measure FIM ambulation, expression items, length of stay, and cost of care. Student s t tests were performed to assess for differences between the two groups. No significant differences were noted between the groups for any of the outcome variables. Although penetrating injuries may have a higher initial mortality, those who survive to come to rehabilitation appear to have similar outcomes to those patients with non penetrating violence related injuries.