期刊
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
卷 94, 期 10, 页码 1855-1860出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2012.10.041
关键词
Cognition; Consciousness disorders; Minimally conscious state; Prognosis; Rehabilitation; Rehabilitation outcome; Traumatic brain injuries; Vegetative state
资金
- National Institute on Disability and Rehabilitation Research, United States Department of Education [H133A060038, H133A070040, H133A070042, H133A070030, H133A070033, H133A070027, H133A080044]
- Health Services Research and Development/Rehabilitation Research and Development Center of Excellence for Maximizing Rehabilitation Outcomes [COE - HFP 09-156]
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 (TRIMS). Setting: Inpatient rehabilitation hospitals participating in the TRIMS 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. (c) 2013 by the American Congress of Rehabilitation Medicine
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