Article

OBJECTIVES: To describe the functional level during sub-acute rehabilitation
after moderate and severe traumatic brain injury (TBI) and to evaluate the impact
of pre-injury and injury-related factors as predictors of early recovery.
METHODS: A prospective study of 55 patients with moderate (n = 21)
and severe (n = 34) TBI who received specialized, inpatient rehabilitation.
Functional level was assessed by the FIM. Possible predictors were analysed in a
regression model using FIM total score at discharge as outcome. RESULTS: At
discharge from sub-acute rehabilitation, on average 53 (+/-24) days post-injury,
57% of moderate TBI patients and 91% of severe TBI patients were still disabled
with a FIM score < 126. The disability was mild (FIM 109-126) in 95% with
moderate TBI and in 62% with severe TBI. The disability was severe (FIM < 72) in
24% with severe TBI. Only one patient did not improve. Predictors of functional
level at discharge from rehabilitation were Glasgow Coma Scale (GCS) score at
rehabilitation admission (B = 5.991), FIM total score at rehabilitation admission
(B = 0.393), length of stay (LOS) in the rehabilitation unit (B = 0.264) and
length of Post-Traumatic Amnesia (PTA) (B = -0.120). Together, these predictors
explained 86% of variance of FIM total scores at discharge. CONCLUSION: Less than
half of moderate TBI patients reached a normal functional level at discharge from
sub-acute rehabilitation. A short PTA period, a high GCS score and FIM score at
admission to rehabilitation and a longer stay in the rehabilitation unit were
positive predictors of functional level at discharge.

Langue : ANGLAIS