Cullen Nora, Krakowski Aneta, Taggart Christina
Toronto Rehabilitation Institute -- University Health Network , Toronto, ON , Canada .
Brain Inj. 2014;28(2):189-95. doi: 10.3109/02699052.2013.862738.
To examine the utility of three common measures as predictors of return to driving after traumatic brain injury (TBI): Glasgow Coma Score (GCS) within the first 24 hours of injury and both Functional Independence Measure (FIM) and Disability Rating Scale (DRS) at rehabilitation admission.
Seventy-two participants with TBI completed a questionnaire that assessed return to driving post-TBI, as measured by reinstatement of the driver's license. Participants who did not return to driving for non-medical reasons or who had not driven pre-injury and did not obtain a driver's license post-injury were excluded from analysis. This produced a final sample of 59 participants. Scores on GCS, FIM and DRS, leveraged from an existing database, were compared between participants who had and those who had not returned to driving post-injury. Multiple logistic regression analysis was performed to determine the relationship of each predictor variable to return to driving.
Only the FIM score at rehabilitation admission was significantly associated with return to driving (p < 0.01). FIM score had a sensitivity of 72% and specificity of 73% with respect to return to driving.
This study supports the use of FIM at rehabilitation admission as a predictor of return to driving. Future studies should be directed at identifying other measures to be used in combination with FIM to accurately predict return to driving post-TBI.
探讨三种常用指标作为创伤性脑损伤(TBI)后恢复驾驶预测指标的效用:受伤后24小时内的格拉斯哥昏迷评分(GCS)以及康复入院时的功能独立性测量(FIM)和残疾评定量表(DRS)。
72名TBI患者完成了一份问卷,该问卷通过恢复驾照来评估TBI后的恢复驾驶情况。因非医疗原因未恢复驾驶或受伤前未驾驶且受伤后未获得驾照的参与者被排除在分析之外。最终样本为59名参与者。比较了受伤后恢复驾驶和未恢复驾驶的参与者在GCS、FIM和DRS上的得分,这些得分来自现有的数据库。进行多因素逻辑回归分析以确定每个预测变量与恢复驾驶之间的关系。
只有康复入院时的FIM得分与恢复驾驶显著相关(p < 0.01)。FIM得分对于恢复驾驶的敏感性为72%,特异性为73%。
本研究支持将康复入院时的FIM作为恢复驾驶的预测指标。未来的研究应致力于确定与FIM联合使用的其他指标,以准确预测TBI后的恢复驾驶情况。