title: Predictors of improved functional outcome following inpatient rehabilitation for patients with traumatic brain injury.
abstract: OBJECTIVE
  To determine factors associated with response to inpatient rehabilitation treatment among TBI patients.
  
  
  METHODS
  Inpatient rehabilitation service at a Level I trauma center.
  
  
  METHODS
  Moderate-severe TBI patients ages ≥ 18years old admitted between January 1, 2002 and December 31, 2012.
  
  
  METHODS
  Response to inpatient rehabilitation, measured by the Functional Independence Measure (FIM) score.
  
  
  METHODS
  Retrospective cohort study.
  
  
  RESULTS
  Of 1,984 patients treated for TBI, 184 (10.8%) underwent inpatient rehabilitation. The largest proportion of patients improved in mobility (98.9%), followed by self-care (93.7%), communication/social cognition (84.0%), and sphincter control (65.7%). Of these, 99 (53.8%) improved by 2 or more levels of functional independence and were considered rehabilitation responders. Responders were younger (53.1 years vs. 63.8, p < 0.01), had longer average rehabilitation stays (15.4 days vs. 12.2, p < 0.01), and were less likely to have an admission SBP <100 mmHg (7.1% vs. 17.1%, p = 0.01). On multivariate analysis, normotension at admission (AOR 0.06, p = 0.01) and longer rehabilitation LOS (AOR 1.11, p < 0.01) were associated with a response to inpatient rehabilitation.
  
  
  CONCLUSIONS
  Of the TBI patients who qualified for same-center inpatient rehabilitation, approximately half responded to treatment. Longer rehabilitation time and normotension at admission predicted response to rehabilitation. Further efforts are necessary to identify and optimize TBI patients for inpatient rehabilitation.
authors: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Fred S
authors: FS
authors: McLafferty
authors: Department of Surgery, Division of Acute Care Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Galinos
authors: G
authors: Barmparas
authors: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Alicia
authors: A
authors: Ortega
authors: Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Pamela
authors: P
authors: Roberts
authors: Department of Surgery, Division of Acute Care Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Ara
authors: A
authors: Ko
authors: Department of Surgery, Division of Acute Care Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Megan
authors: M
authors: Harada
authors: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Miriam
authors: M
authors: Nuño
authors: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Keith L
authors: KL
authors: Black
authors: Department of Surgery, Division of Acute Care Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Eric J
authors: EJ
authors: Ley
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology / Q000534:rehabilitation*; D015331:Cohort Studies; D003142:Communication; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012648:Self Care; D012919:Social Behavior; D014193:Trauma Centers; D016896:Treatment Outcome
keywords: Glasgow Coma Scale (GCS); Traumatic brain injury (TBI); hypotension; inpatient rehabilitation; rehabilitation responder