Predicting level of independence following moderate and severe traumatic brain injury

Philip Schatz

doi:10.17918/00008397

Demographic and rehabilitation outcome data were analyzed for 300 moderate and severe traumatic brain injury patients enrolled in the Pennsylvania Head Injury Program (PHIP) between 1985 and 1994. Predictive factors of outcome following traumatic brain injury were identified. A ten-point level of independence rating scale was constructed as a measure for rehabilitation outcome, measuring need for supervision for: communication, self-care routines, basic living skills, daily living, and employment. Post-hoc interrater reliability was significantly high at.80. Multiple regression analysis identified Disability Rating Scale (DRS) scores at twelve to eighteen months post injury as the most significant predictor of level of independence up to nine years post injury. DRS scores accounted for 49% of the variance in the level of independence measure. Subjects matched for severity of injury and functional ability at discharge from primary rehabilitation were divided into groups on the basis of number of rehabilitation facilities attended. Analyses of variance revealed that subjects who attended fewer rehabilitation facilities spent significantly fewer days in primary rehabilitation and were more likely to be discharged to the care of their families. Subjects attending zero to three subsequent rehabilitation facilities after acute rehabilitation showed no significant difference on level of independence ratings, DRS scores, and Rancho Los Amigos Level of Cognitive Functioning ratings up to nine years post injury. It is hypothesized that subsequent rehabilitation hospitalizations do not significantly improve scores on outcome measures because these admissions occur in the absence of appropriate discharge placements following primary rehabilitation. Trends in acute and rehabilitation hospitalization statistics for TBI between 1986 and 1993 were analyzed. Analysis of trends in hospitalization statistics between 1986 and 1993 revealed significant decreases in mean acute care and rehabilitation length of stay (20 and 60 days, respectively) for TBI survivors, with no significant effect on level of independence.

Predicting level of independence following moderate and severe traumatic brain injury

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Predicting level of independence following moderate and severe traumatic brain injury

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