Functional outcomes in traumatic disorders of consciousness: 5-year outcomes from the National Institute on Disability and Rehabilitation Research traumatic brain injury model systems

John Whyte, Risa Nakase-Richardson, Flora M. Hammond, Shane McNamee, Joseph T. Giacino, Kathleen Kalmar, Brian D. Greenwald, Stuart A. Yablon, Lawrence J. Horn

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1855-1860
Number of pages6
JournalArchives of physical medicine and rehabilitation
Volume94
Issue number10
DOIs
StatePublished - Oct 1 2013

Keywords

  • Cognition
  • Consciousness disorders
  • Minimally conscious state
  • Prognosis
  • Rehabilitation
  • Rehabilitation outcome
  • Traumatic brain injuries
  • Vegetative state

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

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