Schatz Philip, Hillary Frank G, Moelter Stephen T, Chute Douglas L
Saint Joseph's University, Philadelphia, Pennsylvania 19131, USA.
J Head Trauma Rehabil. 2002 Dec;17(6):510-25. doi: 10.1097/00001199-200212000-00003.
To develop a measure suitable for retrospective analysis of qualitative brain injury outcome data, the Functional Independence Level (FIL), and document its reliability, validity, and utility.
Retrospective analysis of existing records, with inclusion based on availability of records, and quantitative or qualitative documentation of functional status at a minimum of 1.5 years after injury.
Statewide acute and postacute rehabilitation facilities, as part of a State Head Injury Program.
A total of 338 individuals, with documented moderate to severe traumatic brain injury; primarily males ages 16 to 45.
Disability Rating Scale (DRS) at discharge from primary rehabilitation, Living Situation and Functional Independence Level coded from information in postacute rehabilitation reports, at an average of approximately 6 years after injury.
Inter-rater reliability coefficients for FIL ratings extracted from rehabilitation records, and between retrospective and in vivo assessments were highly significant. DRS scores at discharge from primary rehabilitation predicted a significant amount of variance in FIL scores at an average of 5 years after injury, and DRS scores remained a stable and significant predictor of FIL scores as the time period between discharge from rehabilitation and outcome ratings increased to 10 years after injury. FIL ratings were significantly lower for individuals living in residential facilities than those living with their families, as compared to living alone.
The FIL is a reliable and useful tool for retrospective and prospective assessments of rehabilitation outcome. Gains made during primary rehabilitation by people with severe traumatic brain injury are generally maintained at long-term follow up. Retrospective ratings using the DRS and FIL can help guide postacute rehabilitation planning within state or regional head injury programs.
开发一种适用于对定性脑损伤结局数据进行回顾性分析的测量方法——功能独立水平（FIL），并记录其信度、效度和实用性。
对现有记录进行回顾性分析，根据记录的可获得性纳入研究对象，并对损伤后至少1.5年的功能状态进行定量或定性记录。
作为州脑损伤项目的一部分，全州范围内的急性和亚急性康复设施。
共有338名有中度至重度创伤性脑损伤记录的个体；主要为16至45岁的男性。
初次康复出院时的残疾评定量表（DRS），根据亚急性康复报告中的信息编码的生活状况和功能独立水平，平均在损伤后约6年。
从康复记录中提取的FIL评分的评分者间信度系数，以及回顾性评估与现场评估之间的信度系数非常显著。初次康复出院时的DRS评分预测了损伤后平均5年FIL评分的大量变异，并且随着从康复出院到结局评定的时间间隔增加到损伤后10年，DRS评分仍然是FIL评分的稳定且显著的预测指标。与独自生活相比，居住在寄宿设施中的个体的FIL评分显著低于与家人同住的个体。
FIL是一种用于康复结局回顾性和前瞻性评估的可靠且有用的工具。重度创伤性脑损伤患者在初次康复期间取得的进展在长期随访中通常得以维持。使用DRS和FIL进行回顾性评分可帮助指导州或地区脑损伤项目内的亚急性康复计划。
