Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 1 , Pages 163-170, January 2008

Characteristics and Rehabilitation Outcomes Among Patients With Blast and Other Injuries Sustained During the Global War on Terror

  • Nina A. Sayer, PhD

      Affiliations

    • Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, MN
    • Department of Medicine, University of Minnesota, Twin Cities Campus, Minneapolis, MN
    • Department of Psychology, University of Minnesota, Twin Cities Campus, Minneapolis, MN
    • Corresponding Author InformationReprint requests to Nina A. Sayer, PhD, Center for Chronic Disease Outcomes Research-152/2E, VA Medical Center, One Veterans Dr, Minneapolis, MN 55417
    • ,
  • Christine E. Chiros, MA

      Affiliations

    • Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, MN
    • ,
  • Barbara Sigford, MD

      Affiliations

    • Department of Medicine, University of Minnesota, Twin Cities Campus, Minneapolis, MN
    • Physical Medicine and Rehabilitation, VA Medical Center, Minneapolis, MN
    • ,
  • Steven Scott, DO

      Affiliations

    • Physical Medicine and Rehabilitation, James A. Haley VA Medical Center, Tampa, FL
    • University of South Florida College of Medicine, Tampa, FL
    • ,
  • Barbara Clothier, MS, MA

      Affiliations

    • Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, MN
    • ,
  • Treven Pickett, PsyD

      Affiliations

    • Defense and Veterans Brain Injury Center and McGuire VA Medical Center, Richmond, VA
    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA
    • ,
  • Henry L. Lew, MD

      Affiliations

    • Defense and Veterans Brain Injury Center and VA Medical Center, Palo Alto, CA
    • School of Medicine, Stanford University, Stanford, CA.

Abstract 

Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, Lew HL. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror.

Objective

To describe characteristics and rehabilitation outcomes among patients who received inpatient rehabilitation for blast and other injuries sustained in Iraq and Afghanistan during the Global War on Terror.

Design

Observational study based on chart review and Department of Veterans Affairs (VA) administrative data.

Setting

The 4 VA polytrauma rehabilitation centers (PRCs).

Participants

Service members (N=188) admitted to a PRC during the first 4 years of the Global War on Terror for injuries sustained during Operation Iraqi Freedom or Operation Enduring Freedom.

Intervention

Multidisciplinary comprehensive rehabilitation program.

Main Outcomes Measures

Cognitive and motor FIM instrument gain scores and length of stay (LOS).

Results

Most war-injured patients had traumatic brain injury, injuries to several other body systems and organs, and associated pain. Fifty-six percent had blast-related injuries, and the pattern of injuries was unique among those with injuries secondary to blasts. Soft tissue, eye, oral and maxillofacial, otologic, penetrating brain injuries, symptoms of post-traumatic stress disorder, and auditory impairments were more common in blast-injured patients than in those with war injuries of other etiologies. The mechanism of the injury did not predict functional outcomes. LOS was variable, particularly for those with blast injuries. Patients with low levels of independence at admissions made the most progress but remained more dependent at discharge compared with other PRC patients. The rate of gain was slower in this low-functioning group.

Conclusions

Blasts produce a unique constellation of injuries but do not make a unique contribution to functional gain scores. Findings underscore the need for assessment and treatment of pain and mental health problems among patients with polytrauma and blast-related injuries. Patients with polytrauma have lifelong needs, and future research should examine needs over time after community re-entry.

Key Words: Brain injuries, Length of stay, Outcome assessment (health care), Rehabilitation

 

 Supported by the VA Health Service Research & Development (grant no. RRP 06-150).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)00408-X

doi:10.1016/j.apmr.2007.05.025

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 1 , Pages 163-170, January 2008

Article Tools

* Image Usage & Resolution