Sandhaug Maria, Andelic Nada, Vatne Anita, Seiler Stephen, Mygland Aase
Faculty of Health and Sports, Agder University, Kristiansand, Norway.
Brain Inj. 2010;24(5):740-7. doi: 10.3109/02699051003652849.
To describe the functional level during sub-acute rehabilitation after moderate and severe traumatic brain injury (TBI) and to evaluate the impact of pre-injury and injury-related factors as predictors of early recovery.
A prospective study of 55 patients with moderate (n = 21) and severe (n = 34) TBI who received specialized, inpatient rehabilitation. Functional level was assessed by the FIM. Possible predictors were analysed in a regression model using FIM total score at discharge as outcome.
At discharge from sub-acute rehabilitation, on average 53 (+/-24) days post-injury, 57% of moderate TBI patients and 91% of severe TBI patients were still disabled with a FIM score < 126. The disability was mild (FIM 109-126) in 95% with moderate TBI and in 62% with severe TBI. The disability was severe (FIM < 72) in 24% with severe TBI. Only one patient did not improve. Predictors of functional level at discharge from rehabilitation were Glasgow Coma Scale (GCS) score at rehabilitation admission (B = 5.991), FIM total score at rehabilitation admission (B = 0.393), length of stay (LOS) in the rehabilitation unit (B = 0.264) and length of Post-Traumatic Amnesia (PTA) (B = -0.120). Together, these predictors explained 86% of variance of FIM total scores at discharge.
Less than half of moderate TBI patients reached a normal functional level at discharge from sub-acute rehabilitation. A short PTA period, a high GCS score and FIM score at admission to rehabilitation and a longer stay in the rehabilitation unit were positive predictors of functional level at discharge.
描述中度和重度创伤性脑损伤（TBI）亚急性康复期间的功能水平，并评估伤前及与损伤相关因素作为早期恢复预测指标的影响。
对55例中度（n = 21）和重度（n = 34）TBI患者进行前瞻性研究，这些患者接受了专门的住院康复治疗。使用FIM评估功能水平。在回归模型中分析可能的预测指标，以出院时的FIM总分作为结果。
在亚急性康复出院时，平均伤后53（±24）天，57%的中度TBI患者和91%的重度TBI患者FIM评分<126，仍有残疾。中度TBI患者中95%、重度TBI患者中62%的残疾为轻度（FIM 109 - 126）。重度TBI患者中24%的残疾为重度（FIM < 72）。只有1例患者没有改善。康复出院时功能水平的预测指标为康复入院时的格拉斯哥昏迷量表（GCS）评分（B = 5.991）、康复入院时的FIM总分（B = 0.393）、康复单元住院时间（LOS）（B = 0.264）和创伤后遗忘症（PTA）时长（B = -0.120）。这些预测指标共同解释了出院时FIM总分变异的86%。
亚急性康复出院时，不到一半的中度TBI患者达到正常功能水平。PTA期短、康复入院时GCS评分和FIM评分高以及在康复单元停留时间长是出院时功能水平的积极预测指标。
