title: Cognition in patients with burn injury in the inpatient rehabilitation population.
abstract: OBJECTIVE
  To analyze potential cognitive impairment in patients with burn injury in the inpatient rehabilitation population.
  
  
  METHODS
  Rehabilitation patients with burn injury were compared with the following impairment groups: spinal cord injury, amputation, polytrauma and multiple fractures, and hip replacement. Differences between the groups were calculated for each cognitive subscale item and total cognitive FIM. Patients with burn injury were compared with the other groups using a bivariate linear regression model. A multivariable linear regression model was used to determine whether differences in cognition existed after adjusting for covariates (eg, sociodemographic factors, facility factors, medical complications) based on previous studies.
  
  
  METHODS
  Inpatient rehabilitation facilities.
  
  
  METHODS
  Data from Uniform Data System for Medical Rehabilitation from 2002 to 2011 for adults with burn injury (N=5347) were compared with other rehabilitation populations (N=668,816).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Comparison of total cognitive FIM scores and subscales (memory, verbal comprehension, verbal expression, social interaction, problem solving) for patients with burn injury versus other rehabilitation populations.
  
  
  RESULTS
  Adults with burn injuries had an average total cognitive FIM score ± SD of 26.8±7.0 compared with an average FIM score ± SD of 28.7±6.0 for the other groups combined (P<.001). The subscale with the greatest difference between those with burn injury and the other groups was memory (5.1±1.7 compared with 5.6±1.5, P<.001). These differences persisted after adjustment for covariates.
  
  
  CONCLUSIONS
  Adults with burn injury have worse cognitive FIM scores than other rehabilitation populations. Future research is needed to determine the impact of this comorbidity on patient outcomes and potential interventions for these deficits.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; National Intrepid Center of Excellence, Intrepid Spirit One, Fort Belvoir Community Hospital, Fort Belvoir, VA.
authors.forename: Maulik
authors.initials: M
authors.lastname: Purohit
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Nadler
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
authors.forename: Katie
authors.initials: K
authors.lastname: Mathews
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
authors.forename: Chloe
authors.initials: C
authors.lastname: Slocum
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
authors.forename: Paul
authors.initials: P
authors.lastname: Gerrard
authors.affiliation: Uniform Data System for Medical Rehabilitation, Amherst, NY; Health Department, State University of New York at Cortland, Cortland, NY.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: DiVita
authors.affiliation: Sumner Redstone Burn Center, Surgical Services Massachusetts General Hospital, Harvard Medical School, Boston, MA; Shriners Hospitals for Children-Boston, Boston, MA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital, Boston, MA.
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
authors.forename: Karen
authors.initials: K
authors.lastname: Kowalske
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Shriners Hospitals for Children-Boston, Boston, MA; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA. Electronic address: jcschneider@partners.org.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology; D002056:Burns / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008606:Mental Processes; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000523:psychology
keywords: Burns; Cognition; Outcome measures; Rehabilitation