Article

OBJECTIVE: To examine trajectories of functional recovery after rehabilitation
for traumatic brain injury (TBI). DESIGN: Prospective study. SETTING: Inpatient
rehabilitation hospitals in the Uniform Data System for Medical Rehabilitation.
PARTICIPANTS: A subset of individuals receiving inpatient rehabilitation services
for TBI from 2002 to 2010 who also had postdischarge measurement of functional
independence (N=16,583). INTERVENTIONS: Inpatient rehabilitation. MAIN OUTCOMES
MEASURES: Admission, discharge, and follow-up data were obtained from the Uniform
Data System for Medical Rehabilitation. We used latent class mixture models to
examine recovery trajectories for both cognitive and motor functioning as
measured by the FIM instrument. RESULTS: Latent class models identified 3
trajectories (low, medium, high) for both cognitive and motor FIM subscales.
Factors associated with membership in the low cognition trajectory group included
younger age, male sex, racial/ethnic minority, Medicare or Medicaid (vs
commercial or other insurance), comorbid conditions, and greater duration from
injury date to rehabilitation admission date. Factors associated with membership
in the low motor trajectory group included older age, racial/ethnic minority,
Medicare or Medicaid coverage, comorbid conditions, open head injury, and greater
duration to admission. CONCLUSIONS: Standard approaches to assessing recovery
patterns after TBI obscure differences between subgroups with trajectories that
differ from the overall mean. Select demographic and clinical characteristics can
help classify patients with TBI into distinct functional recovery trajectories,
which can enhance both patient-centered care and quality improvement efforts.
CI - Copyright (c) 2017. Published by Elsevier Inc.

Langue : ANGLAIS