Article

Despite the increasing rate of survival from hypoxic-ischemic brain
injury (HIBI), there is a paucity of evidence on the long-term functional
outcomes after inpatient rehabilitation among these nontrauma patients compared
to patients with traumatic brain injury (TBI). OBJECTIVES: To compare functional
and psychosocial outcomes of patients with HIBI to those of case-matched patients
with TBI 4-11 years after brain insult. DESIGN: Retrospective, matched
case-controlled study. METHODS: Data at the time of rehabilitation admission and
discharge were collected as part of a larger acquired brain injury (ABI) database
at Toronto Rehabilitation Institute (TRI) between 1999 and 2009. This study
consisted of 11 patients with HIBI and 11 patients with TBI that attended the
neuro-rehabilitation day program at TRI during a similar time frame and were
matched on age, admission Functional Independence Measure (FIM) scores, and acute
care length of stay (ALOS). At 4-11 years following brain insult, patients were
reassessed using the FIM, Disability Rating Scale (DRS), Personal Health
Questionnaire Depression Scale (PHQ-9), and the Mayo-Portland Adaptability
Inventory 4 (MPAI-4). RESULTS: At follow-up, patients with HIBI had significantly
lower FIM motor and cognitive scores than patients with TBI (75.3 +/- 20.6 versus
88.1 +/- 4.78, P < .05, and 25.5 +/- 5.80 versus 32.7 +/- 2.54, P <.05,
respectively) despite having a similar time frame postinsult (ie, 4-11 years). In
addition, there were significant differences in motor and total FIM change from
admission to follow-up between HIBI and TBI patients (P < .05). Patients with
HIBI also had significantly lower scores on the DRS, PHQ-9, and total MPAI-4 at
follow-up (P < .05). CONCLUSIONS: The study results suggest that patients with
HIBI achieve less long-term functional improvements compared to patients with
TBI. Further research is warranted to compare the components of inpatient
rehabilitation while adjusting for demographics and clinical characteristics
between these 2 groups of patients. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS