Article

OBJECTIVE: To evaluate the clinical and economic burden of traumatic brain injury
(TBI) in people with traumatic spinal cord injury (SCI).
DESIGN: Prospective,
case-matched control study. SETTING: Inpatient spinal cord rehabilitation
program. PARTICIPANTS: Patients (n=10) diagnosed with traumatic SCI and
concomitant TBI matched to an SCI only control group. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Inpatient rehabilitation length of stay,
health care costs (patient care hours), clinician resource allocation, behavioral
and critical incidents, FIM, Personality Assessment Inventory, and
neuropsychological assessment findings. RESULTS: Prolonged loss of consciousness,
increased rehabilitation costs, and greater demands on clinician recourses
(trend) were found in the SCI with TBI group relative to the SCI-only group.
Neuropsychological test performance was significantly worse in the SCI with TBI
group, while the FIM cognition score did not discriminate because of ceiling
effects. Greater evidence of psychopathology was observed in the SCI with TBI
group. CONCLUSIONS: The presence of TBI in SCI has a range of clinical and
economic consequences. This dual diagnosis has the potential to affect SCI
rehabilitation negatively, as well as quality of life and reintegration in the
community. Specialized care appears to be needed to improve outcomes and to
minimize clinical and economic burden, but further research is required.

Langue : ANGLAIS