title: Burn Injuries and Their Impact on Cognitive-Communication Skills in the Inpatient Rehabilitation Setting.
abstract: The prevalence and extent of cognitive-communication disorders and factors that have impact on outcomes are examined in the burn population within an inpatient rehabilitation facility. A retrospective data analysis was conducted on adults diagnosed with burn injury (n = 144). Descriptive statistics were used to identify the prevalence of cognitive-communication deficits on admission and discharge. The main outcomes were cognitive-communication ratings on discharge from inpatient rehabilitation as measured by the memory and problem-solving domains of the Functional Independence Measure (FIM) and composite score of the Functional Communication Measure (FCM). Medical, demographic and rehabilitation predictors of the main outcomes were assessed using regression analyses. On admission to inpatient rehabilitation, 79% of the total population presented with cognitive-communication impairments, and of them, 27% presented with persistent deficits on discharge. Admission FIM memory score, marital status, and age were significant predictors of discharge FIM memory score. Admission FIM problem-solving score, age, marital status, and prehospital living-with were significant predictors of discharge FIM problem-solving score. Admission FCM score and age were significant predictors of discharge FCM cognitive score. Persons with burn injuries are at risk for cognitive-communication impairments, which may persist after inpatient rehabilitation. FIM data obtained on admission can be used as a screening tool to identify these at-risk patients. Future work is needed to assess the efficacy of speech-language pathologist intervention for cognitive-communication deficits within the burn injury population.
authors.affiliation: From the *Department of Speech-Language Pathology, Spaulding Rehabilitation Hospital, Boston, Massachusetts; †Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, Boston; ‡Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts; §Sumner Redstone Burn Center, Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston; and ‖Shriners Hospitals for Children, Boston, Massachusetts.
authors.forename: Carla Tierney
authors.initials: CT
authors.lastname: Hendricks
authors.forename: Kristin
authors.initials: K
authors.lastname: Camara
authors.forename: Kathryn
authors.initials: K
authors.lastname: Violick Boole
authors.forename: Maureen F
authors.initials: MF
authors.lastname: Napoli
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000523:psychology* / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000453:epidemiology*; D003147:Communication Disorders / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult