Authors

  1. Pape, Theresa DrPH, MA
  2. Lundgren, Sandra PhD, ABPP
  3. Heinemann, Allen PhD, ABPP
  4. Guernon, Ann MS
  5. Hurder, Anita Giobbie MS
  6. Roth, Heidi MS, PT

Article Content

Objectives: To report findings regarding the prediction of functional outcomes 1 year after severe traumatic brain injury (TBI) using data available when the patient is unconscious. Hypothesis: Functional outcomes, 1-year after severe TBI, can be predicted using data collected during coma recovery. Participants: Persons unconscious after severe brain injury who present to inpatient (IP) rehabilitation hospitals in the Midwestern United States are enrolled in an ongoing study. Methods: After inpatient rehabilitation discharge, each subject is followed monthly and the final outcome interview is conducted 1 year after injury. The final interview includes 70 questions; 32 of these questions are from the Craig Handicap Assessment and Reporting Technique (CHART). A sample of 63 persons was abstracted from the study database to examine the predictability of 42 independent variables and 16 dichotomous outcomes. Results: Twelve of 16 dichotomous outcomes were found to be significantly predictable (P < .05). Ten predictors were found to be significant (P < .05): etiology, presence of urinary tract infection, seizure, hypertension, veteran benefit eligibility, health insurance, marital status at injury, whether or not recovery of consciousness occurred within 1 year, the number of days between injury and admission to IP rehabilitation, and the average length of IP rehabilitation stay. Eight of the 10 variables are available early after injury or during coma recovery. Conclusions: Functional outcomes 1 year after severe TBI can be predicted early in the recovery trajectory. Families and treating clinicians can use the prognostic information to guide resource planning. Families and friends can use the prognostic information to support their adjustment to and coping with disability.

 

REFERENCE

 

1. Pape TL-B, Heinemann A, Kelly JP, Hurder AG, Lundgren S. A measure of neurobehavioral functioning after coma. Part I: Theory, reliability, and validity of the Disorders of Consciousness Scale. J Rehabil Res Dev. 2005;42(1):1-18.