Outcomes of Early Rehabilitation in Traumatic Brain Injury

Abstract

<h3>Research Objectives</h3> To determine the functional outcomes and the associated clinical predictors of early rehabilitation of patients with all TBI severity. <h3>Design</h3> Retrospective analysis. <h3>Setting</h3> Acute inpatient rehabilitation (AIR) unit. <h3>Participants</h3> A total of 491 patients with head trauma were screened and reviewed between 1 November 2010 and 30 October 2012 within 72 hours of admission to the neurosurgical ward in an acute tertiary hospital. Patients who fulfilled the following criteria were then recommended and transferred to AIR: (1) presence of impairments or disabilities which could benefit from a comprehensive inpatient rehabilitation programme, (2) potential to participate in a goal-oriented rehabilitation programme and (3) medical stability to participate in a rehabilitation setting. One hundred and sixteen patients were directly transferred to AIR. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Rehabilitation Length of Stay (RLOS); Functional Independence Measure (FIM); FIM gain and FIM efficiency. <h3>Results</h3> The median age of the patients transferred to AIR was 72.0 (IQR 58.3-79.8). Most sustained a mild injury (75.9%). The total functional and motor gains after AIR were significant (p< 0.001). The median total FIM gain was 12.00 (IQR 2.00-41.00) points. The median FIM efficiency was 0.55 (IQR 0.67-1.58) points/day. The median RLOS (days) was 20.50 (IQR 12.25-30.50). Increased age, complications, high motor admission FIM (AFIM) and long RLOS were associated with lower FIM gain and lower FIM efficiency. <h3>Conclusions</h3> Our study showed majority of the patients selected for AIR were mild TBI and older patients. There was functional improvement in patients with TBI receiving early rehabilitation. Increased age, presence of complications, high motor AFIM and increased RLOS were associated with lower FIM gain and lower FIM efficiency. <h3>Author(s) Disclosures</h3> Nil.