Traumatic brain injury in patients with traumatic spinal cord injury: clinical and economic consequences.
OBJECTIVE
To evaluate the clinical and economic burden of traumatic brain injury (TBI) in people with traumatic spinal cord injury (SCI).


METHODS
Prospective, case-matched control study.


METHODS
Inpatient spinal cord rehabilitation program.


METHODS
Patients (n=10) diagnosed with traumatic SCI and concomitant TBI matched to an SCI only control group.


METHODS
Not applicable.


METHODS
Inpatient rehabilitation length of stay, health care costs (patient care hours), clinician resource allocation, behavioral and critical incidents, FIM, Personality Assessment Inventory, and neuropsychological assessment findings.


RESULTS
Prolonged loss of consciousness, increased rehabilitation costs, and greater demands on clinician recourses (trend) were found in the SCI with TBI group relative to the SCI-only group. Neuropsychological test performance was significantly worse in the SCI with TBI group, while the FIM cognition score did not discriminate because of ceiling effects. Greater evidence of psychopathology was observed in the SCI with TBI group.


CONCLUSIONS
The presence of TBI in SCI has a range of clinical and economic consequences. This dual diagnosis has the potential to affect SCI rehabilitation negatively, as well as quality of life and reintegration in the community. Specialized care appears to be needed to improve outcomes and to minimize clinical and economic burden, but further research is required.
Bradbury
Cheryl L
CL
Toronto Rehabilitation Institute, Toronto, ON, Canada. bradbury.cheryl@torontorehab.on.ca
Wodchis
Walter P
WP
Mikulis
David J
DJ
Pano
Ephrem G
EG
Hitzig
Sander L
SL
McGillivray
Colleen F
CF
Ahmad
Fahad N
FN
Craven
B Catherine
BC
Green
Robin E
RE
D000328:Adult; D001930:Brain Injuries / Q000191:economics / Q000534:rehabilitation*; D004185:Disability Evaluation; D005500:Follow-Up Studies; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008875:Middle Aged; D009104:Multiple Trauma / Q000503:physiopathology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000191:economics / Q000534:rehabilitation*; D055815:Young Adult