title: Rehabilitation after trauma; does age matter?
abstract: BACKGROUND
  Variability exits in the ability to predict overall recovery after trauma and inpatient rehabilitation. The aim of this study was to identify factors predicting functional improvement in trauma patients undergoing inpatient rehabilitation.
  
  
  METHODS
  We performed a 3-y retrospective cohort analysis on a prospectively collected database of all trauma patients discharged from a level I trauma center to a single inpatient rehabilitation center. Patient's Functional Independence Measures (FIM) scores on hospital discharge and on discharge from the rehabilitation center were collected. Delta FIM was defined as the difference in FIM between rehabilitation center discharge and hospital discharge. Multiple linear regressions were performed to identify hospital admission factors associated with delta FIM.
  
  
  RESULTS
  We included 160 patients, 69% were male, mean age 54.6 ± 22 y, and median Injury Severity Score 14 [10-50]. Based on rehabilitation admission FIM scores, 29 were totally dependent and 131 were partially dependent. The mean change in FIM was 39.4 ± 13. Age, gender, Glasgow Coma Scale on presentation, Injury Severity Score, systolic blood pressure on presentation, and intensive care unit length of stay were not predictive of delta FIM. Hospital length of stay and head Abbreviated Injury Score on hospital admission were negative predictors of delta FIM.
  
  
  CONCLUSIONS
  In our study, age as an independent factor was not predictive of functional outcome after injury. The extent of head injury continues to negatively affect the overall functional improvement based on FIM.
authors.affiliation: Division of Trauma, Critical Care, and Acute Care Surgery, Department of Surgery, University of Arizona, Tucson, Arizona 85727, USA. bjoseph@surgery.arizona.edu
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
authors.forename: Viraj
authors.initials: V
authors.lastname: Pandit
authors.forename: Hassan
authors.initials: H
authors.lastname: Aziz
authors.forename: Andrew
authors.initials: A
authors.lastname: Tang
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.forename: Julie
authors.initials: J
authors.lastname: Wynne
authors.forename: Paul
authors.initials: P
authors.lastname: Hsu
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.forename: Lynn
authors.initials: L
authors.lastname: Gries
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000534:rehabilitation*; D016208:Databases, Factual; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000534:rehabilitation*
keywords: Age and rehabilitation; Functional Independence Measure; Functional improvement; Predicting outcomes after trauma; Rehabilitation after trauma