期刊
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
卷 101, 期 7, 页码 1260-1264出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2020.01.015
关键词
Brain injuries; Communication; Consciousness disorders; Rehabilitation
资金
- National Institute on Disability, Independent Living, and Rehabilitation Research within the Administration for Community Living, Department of Health and Human Services [90DPTB0011]
- University of Lie`ge (LEAR Foundation)
- Wallonia-Brussels Federation
- Wallonie-Bruxelles International (WBI.World)
- Tiny Blue Dot Foundation
- James S. McDonnell Foundation
Objective: Characterize the temporal profile of recovery of communication after severe brain injury. Design: Retrospective cohort study. Setting: Inpatient rehabilitation hospital. Participants: Patients with severe acquired brain injury and no evidence of communication on the Coma Recovery Scale-Revised (CRS-R) (N=175). Main Outcome Measures: Time from injury to recovery of intentional communication (IC, inconsistent yes/no responses) and functional communication (FC, consistent and accurate yes/no responses) on the CRS-R Communication subscale. Results: Patients (N=175) were included in the primary observation period of the first 8 weeks of inpatient rehabilitation (median [interquartile range, IQR]: 48 [27-61] years old, 105 men, 28 [21-38] days postinjury, 100 traumatic etiology). Fifty-four patients (31%) did not recover IC or FC. Thirty patients (17%) recovered IC only (median [IQR] days from injury to IC = 40 [34-54]), 72 patients (41%) recovered IC followed by FC (days from injury to FC=50 [42-61]), and 19 patients (11%) recovered FC without first recovering IC (43 [32-63]). The patients who recovered neither IC nor FC within 8 weeks of admission were admitted to rehabilitation later than those who recovered IC and/or FC (P<.01). Sixteen patients who did not recover communication within 8 weeks of admission to rehabilitation subsequently recovered FC prior to discharge. Conclusions: In patients with severe brain injury receiving inpatient rehabilitation, discernible yes-no responses emerged approximately 6 weeks postinjury and became reliable 1 week later. Approximately 1 in 3 patients did not demonstrate IC or FC within 8 weeks of admission to rehabilitation, although 33% of these individuals recovered communication prior to discharge. In total, 61% of patients recovered FC prior to discharge from rehabilitation. (C) 2020 by the American Congress of Rehabilitation Medicine
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