title: Functional outcomes in traumatic disorders of consciousness: 5-year outcomes from the National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems.
abstract: OBJECTIVE
  To characterize the 5-year outcomes of patients with traumatic brain injury (TBI) not following commands when admitted to acute inpatient rehabilitation.
  
  
  METHODS
  Secondary analysis of prospectively collected data from the National Institute on Disability and Rehabilitation Research-funded Traumatic Brain Injury Model Systems (TBIMS).
  
  
  METHODS
  Inpatient rehabilitation hospitals participating in the TBIMS program.
  
  
  METHODS
  Patients (N=108) with TBI not following commands at admission to acute inpatient rehabilitation were divided into 2 groups (early recovery: followed commands before discharge [n=72]; late recovery: did not follow commands before discharge [n=36]).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  FIM items.
  
  
  RESULTS
  For the early recovery group, depending on the FIM item, 8% to 21% of patients were functioning independently at discharge, increasing to 56% to 85% by 5 years postinjury. The proportion functioning independently increased from discharge to 1 year, 1 to 2 years, and 2 to 5 years. In the late recovery group, depending on the FIM item, 19% to 36% of patients were functioning independently by 5 years postinjury. The proportion of independent patients increased significantly from discharge to 1 year and from 1 to 2 years, but not from 2 to 5 years.
  
  
  CONCLUSIONS
  Substantial proportions of patients admitted to acute inpatient rehabilitation before following commands recover independent functioning over as long as 5 years, particularly if they begin to follow commands before hospital discharge.
authors.affiliation: Moss Rehabilitation Research Institute, Elkins Park, PA. Electronic address: jwhyte@einstein.edu.
authors.forename: John
authors.initials: J
authors.lastname: Whyte
authors.forename: Risa
authors.initials: R
authors.lastname: Nakase-Richardson
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.forename: Shane
authors.initials: S
authors.lastname: McNamee
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Giacino
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kalmar
authors.forename: Brian D
authors.initials: BD
authors.lastname: Greenwald
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Yablon
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Horn
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D003244:Consciousness Disorders / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D010351:Patient Discharge; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012047:Rehabilitation Centers; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cognition; Consciousness disorders; DOC; DRS; Disability Rating Scale; GCS; GOS; Glasgow Coma Score; Glasgow Outcome Scale; MCS; Minimally conscious state; PTA; Prognosis; Rehabilitation; Rehabilitation outcome; TBI; TBIMS; Traumatic Brain Injury Model Systems; Traumatic brain injuries; VS; Vegetative state; disorders of consciousness; minimally conscious state; posttraumatic amnesia; traumatic brain injury; vegetative state