TY - JOUR
T1 - Establishing a prognosis for functional outcome during coma recovery
AU - Pape, Theresa Louise Bender
AU - Lundgren, Sandra
AU - Heinemann, Allen W.
AU - Guernon, Ann
AU - Giobbie-Hurder, Anita
AU - Wang, Jia
AU - Roth, Heidi
AU - Blahnik, Melanie
AU - Williams, Vanessa
N1 - Funding Information:
Funding was provided by the Department of Veterans Affairs (VA), Veterans Health Affairs, Rehabilitation Research and Development Service through career development grants to Dr Theresa Pape (B2632-V & B3302K). A grant from the Nick Kot Charity (Not For Profit) and in kind-contributions from Marianjoy Rehabilitation Hospital and the Minneapolis VA Medical Center (VAMC) also supported this research.
PY - 2006/6
Y1 - 2006/6
N2 - Primary objective: One of the most challenging tasks for clinicians caring for survivors of severe brain injury (BI) is establishing a prognosis, for long-term functional outcome, while the patient is unconscious. The objective of this article is to report findings regarding the prediction of functional outcomes 1-year after severe BI using data available when the patient is unconscious. Research design: Longitudinal prognostication study. Methods and procedures: Persons unconscious after severe BI who present to inpatient (IP) rehabilitation hospitals in the Midwestern US are enrolled in an ongoing study. Each subject is followed for 1-year and the final outcome interview includes ∼70 questions; 32 of these questions are from the Craig Handicap Assessment and Reporting Technique (CHART). A sample of 63 persons was abstracted from the study database to examine the predictability of 42 independent variables and 16 dichotomous outcomes. Main outcomes and results: Twelve of the 16 dichotomous outcomes were found to be significantly predictable (p<0.05). These involve activity, participation, environment and quality of life outcomes. Ten predictors were found to be significant (p<0.05): aetiology (Closed Head Injury vs. Other BI), presence of urinary tract infection (UTI), seizure, hypertension during IP rehabilitation, veteran benefit eligibility, health insurance, marital status at injury, whether or not recovery of consciousness occurred within 1 year, the number of days between injury and admission to acute rehabilitation and the average length of IP rehabilitation stay. Eight of the 10 variables are available early after injury or when the patient is unconscious.
AB - Primary objective: One of the most challenging tasks for clinicians caring for survivors of severe brain injury (BI) is establishing a prognosis, for long-term functional outcome, while the patient is unconscious. The objective of this article is to report findings regarding the prediction of functional outcomes 1-year after severe BI using data available when the patient is unconscious. Research design: Longitudinal prognostication study. Methods and procedures: Persons unconscious after severe BI who present to inpatient (IP) rehabilitation hospitals in the Midwestern US are enrolled in an ongoing study. Each subject is followed for 1-year and the final outcome interview includes ∼70 questions; 32 of these questions are from the Craig Handicap Assessment and Reporting Technique (CHART). A sample of 63 persons was abstracted from the study database to examine the predictability of 42 independent variables and 16 dichotomous outcomes. Main outcomes and results: Twelve of the 16 dichotomous outcomes were found to be significantly predictable (p<0.05). These involve activity, participation, environment and quality of life outcomes. Ten predictors were found to be significant (p<0.05): aetiology (Closed Head Injury vs. Other BI), presence of urinary tract infection (UTI), seizure, hypertension during IP rehabilitation, veteran benefit eligibility, health insurance, marital status at injury, whether or not recovery of consciousness occurred within 1 year, the number of days between injury and admission to acute rehabilitation and the average length of IP rehabilitation stay. Eight of the 10 variables are available early after injury or when the patient is unconscious.
KW - Coma
KW - Functional outcomes
KW - Prognostication
KW - Unconsciousness
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U2 - 10.1080/02699050600676933
DO - 10.1080/02699050600676933
M3 - Article
C2 - 16809207
AN - SCOPUS:33745728990
VL - 20
SP - 743
EP - 758
JO - Brain Injury
JF - Brain Injury
SN - 0269-9052
IS - 7
ER -