Article

OBJECTIVE: To compare patient functional outcomes across Traumatic Brain Injury
Model Systems (TBIMS) rehabilitation centers using an enhanced statistical model
and to determine factors that influence those outcomes. DESIGN: Multicenter
observational cohort study. SETTING: TBIMS centers. PARTICIPANTS: Patients with
traumatic brain injury (TBI) admitted to 19 TBIMS rehabilitation centers from
2003-2012 (N=5505). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Functional outcomes of patients with TBI. RESULTS: Individuals with lower
functional status at the time of admission, longer duration of posttraumatic
amnesia, and higher burden of medical comorbidities continued to have worse
functional outcomes at discharge from inpatient rehabilitation and at the 1-year
follow-up, whereas those who were employed at the time of injury had better
outcomes at both time periods. Risk-adjusted patient functional outcomes for
patients in most TBIMS centers were consistent with previous research. However,
there were wide performance differences for a few centers even after using more
recently collected data, improving on the regression models by adding predictors
known to influence functional outcomes, and using bootstrapping to eliminate
confounds. CONCLUSIONS: Specific patient, injury, and clinical factors are
associated with differences in functional outcomes within and across TBIMS
rehabilitation centers. However, these factors did not explain all the variance
in patient outcomes, suggesting a role of some other predictors that remain unknown.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS