Premium
Long‐Term Functional and Psychosocial Outcomes After Hypoxic‐Ischemic Brain Injury: A Case‐Controlled Comparison to Traumatic Brain Injury
Author(s) -
Harbinson Meredith,
Zarshenas Sareh,
Cullen Nora K.
Publication year - 2017
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2017.04.015
Subject(s) - functional independence measure , medicine , traumatic brain injury , psychosocial , rehabilitation , physical therapy , depression (economics) , physical medicine and rehabilitation , psychiatry , economics , macroeconomics
Background Despite the increasing rate of survival from hypoxic‐ischemic brain injury (HIBI), there is a paucity of evidence on the long‐term functional outcomes after inpatient rehabilitation among these nontrauma patients compared to patients with traumatic brain injury (TBI). Objectives To compare functional and psychosocial outcomes of patients with HIBI to those of case‐matched patients with TBI 4‐11 years after brain insult. Design Retrospective, matched case‐controlled study. Methods Data at the time of rehabilitation admission and discharge were collected as part of a larger acquired brain injury (ABI) database at Toronto Rehabilitation Institute (TRI) between 1999 and 2009. This study consisted of 11 patients with HIBI and 11 patients with TBI that attended the neuro‐rehabilitation day program at TRI during a similar time frame and were matched on age, admission Functional Independence Measure (FIM) scores, and acute care length of stay (ALOS). At 4‐11 years following brain insult, patients were reassessed using the FIM, Disability Rating Scale (DRS), Personal Health Questionnaire Depression Scale (PHQ‐9), and the Mayo‐Portland Adaptability Inventory 4 (MPAI‐4). Results At follow‐up, patients with HIBI had significantly lower FIM motor and cognitive scores than patients with TBI (75.3 ± 20.6 versus 88.1 ± 4.78, P < .05, and 25.5 ± 5.80 versus 32.7 ± 2.54, P <.05, respectively) despite having a similar time frame postinsult (ie, 4‐11 years). In addition, there were significant differences in motor and total FIM change from admission to follow‐up between HIBI and TBI patients ( P < .05). Patients with HIBI also had significantly lower scores on the DRS, PHQ‐9, and total MPAI‐4 at follow‐up ( P < .05). Conclusions The study results suggest that patients with HIBI achieve less long‐term functional improvements compared to patients with TBI. Further research is warranted to compare the components of inpatient rehabilitation while adjusting for demographics and clinical characteristics between these 2 groups of patients. Level of Evidence III