Patients with preexisting medical illness (n = 39) were compared with those without any such illnesses (n = 89). Of 138 screened patients, 128 (93%) had both complete functional outcome data and information regarding all preexisting health conditions in the TBIMS national database. Therefore, 138 patients enrolled in the TBIMS longitudinal study between October 1, 2012, and November 5, 2013, were screened for inclusion in this retrospective study. Collection of preexisting medical illnesses and substance use information was initiated in October 2012. Patients with concomitant spinal cord injury, whose inpatient rehabilitation course exceeded 90 days, or who died during their inpatient rehabilitation stay were excluded from this study. Additional information regarding TBIMS inclusion criteria and the definition of TBI can be found in Dijkers, Harrison-Felix, and Marwitz's historical review of the TBIMS ( 1). TBIMS is a longitudinal multicenter, prospective, observational study of patients aged ≥16 years who sustained a moderate to severe TBI due to blunt or penetrating injuries. This study was part of the Traumatic Brain Injury Model System (TBIMS), with data collected at a center in an urban metroplex in the Southern US ( 1). By screening patients for preexisting medical conditions, multidisciplinary TBI rehabilitation teams can identify patients who require more aggressive treatments or greater length of stay. ![]() The findings showed that specific preexisting medical conditions are independently associated with lower functional and cognitive outcomes for patients with TBI. Those with pre-TBI cancer also had greater auditory-verbal memory deficits. Those with preexisting diabetes/high blood sugar demonstrated poorer visual attention, visuomotor processing speed, and ability to learn and recall verbal information. A history of a heart condition, stroke, or respiratory condition prior to TBI was associated with reduced cognitive flexibility. Results showed that the presence of a heart condition or diabetes/high blood sugar was associated with lower functional outcomes by discharge. The Functional Independence Measure total score and Disability Rating Scale score measured functional outcomes at discharge from inpatient rehabilitation, while the Trail Making Test A and B and Total Trials 1–5 of the California Verbal Learning Test–II measured neuropsychological outcomes in 128 TBI survivors with moderate or severe TBI. This study examined the impact of preexisting illness and substance use on patient rehabilitation outcomes following TBI. Specific preexisting medical illnesses delay recovery after TBI and increase mortality or risk of repeat TBI.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |