Article

OBJECTIVE: To identify, for patients in states of seriously impaired
consciousness, comorbid conditions present during inpatient rehabilitation and
their association with function at 1 year.
DESIGN: Abstracted data from a
prospective cross-sectional observational study with data collection occurring
January 1996 through December 2007. SETTING: Four inpatient rehabilitation
facilities in metropolitan areas. PARTICIPANTS: The study sample of 68
participants is abstracted from a database of 157 patients remaining in states of
seriously impaired consciousness for at least 28 days. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURE: One-year cognitive, motor, and total FIM score.
RESULTS: The most common medical complications during inpatient rehabilitation
for the study sample are active seizures (46%), spasticity (57%), urinary tract
infections (47%), and hydrocephalus with and without shunt (38%). Presence of
>/=3 medical complications during inpatient rehabilitation, controlling for
injury severity, is significantly (P<.05) associated with poorer total FIM and
FIM motor scores 1 year after injury. The presence of hydrocephalus with and
without shunt (r=-.20, -.21, -.18; P </=.15), active seizures (r=-.31, -.22,
-.42), spasticity (r=-.38, -.28, -.40), and urinary tract infections (r=-.25,
-.24, -.26) were significantly (P<.10) associated with total FIM, FIM cognitive,
and FIM motor scores, respectively. CONCLUSIONS: Reported findings indicate that
persons in states of seriously impaired consciousness with higher numbers of
medical complications during inpatient rehabilitation are more likely to have
lower functional levels 1-year postinjury. The findings indicate that persons
with >/=3 medical complications during inpatient rehabilitation are at a higher
risk for poorer functional outcomes at 1 year. It is, therefore, prudent to
evaluate these patients for indications of these complications during inpatient
rehabilitation.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS