Rehabilitation outcomes of terror victims with multiple traumas.
OBJECTIVE
To describe the rehabilitation outcomes of terror victims with multiple traumas, and to compare those outcomes with those of patients with nonterror-related multiple traumas treated in the same rehabilitation facility over the same time period.


METHODS
Retrospective chart reviews.


METHODS
Rehabilitation department in a university hospital in Jerusalem, Israel.


METHODS
Between September 2000 and September 2004, we treated 72 victims of terrorist attacks who had multiple traumas. Among them, 47 (65%) had multiple traumas without central nervous system involvement (MT subgroup), 19 (26%) had multiple traumas with traumatic brain injury (TBI subgroup), and 6 (8%) had multiple traumas with spinal cord injury (SCI subgroup). We matched, according to their types of injury and demographic data, each terror victim with a control patient treated in the same period in our rehabilitation department.


METHODS
Interdisciplinary inpatient and outpatient rehabilitation.


METHODS
Hospital length of stay (LOS) in acute care departments, inpatient and outpatient rehabilitation departments, functional outcome (FIM instrument score), occupational outcome (returning to previous occupation), and psychologic outcome (Solomon PTSD [post-traumatic stress disorder] Inventory).


RESULTS
The mean LOS of terror victims was 218+/-131 days; for the nonterror group it was 152+/-114 days (P<.01). In comparison with the control subgroups, the MT subgroup of terrorist victims had significantly longer LOS in the acute care and outpatient rehabilitation departments (P=.06) and the terror TBI subgroup had a longer LOS in outpatient department only (P<.05). The LOS of the SCI patients, both terror victims and control patients, was significantly longer than that of the other 2 subgroups. The difference between FIM value at entry and discharge (DeltaFIM) was significantly higher for terror victims than for the controls (41.1+/-21.6 vs 30.8+/-21.8, P=.002). This difference was mainly the result of the significantly higher DeltaFIM achieved by the terror MT subgroup than by the MT controls. The rate of PTSD was higher among terror victims than among controls (40.9% vs 24.2%, P=.04). The rate of return to previous occupations was similar between terror victims and nonterror patients (53% vs 46.9%, respectively).


CONCLUSIONS
Victims of terror spent longer periods in rehabilitation than the nonterror group; however, they regained most activity of daily living functions similar to the nonterror group. Despite the higher rate of PTSD, terror victims succeeded in returning to their previous occupations at a similar rate to that of the nonterror group.
Schwartz
Isabella
I
Department of Physical Medicine and Rehabilitation, Hadassah University Hospital, Jerusalem, Israel.
Tsenter
Jeanna
J
Shochina
Mara
M
Shiri
Shimon
S
Kedary
Michal
M
Katz-Leurer
Michal
M
Meiner
Zeev
Z
D000328:Adult; D001930:Brain Injuries / Q000145:classification / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000145:classification / Q000209:etiology / Q000534:rehabilitation*; D012042:Registries; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D023481:Terrorism; D016896:Treatment Outcome