Abstract
Objective
To determine the effect of the established polytrauma/traumatic brain injury (TBI)
infrastructure on immediate posttreatment functional gains, the long-term sustainability
of any gains, and participation-related community reintegration outcomes in a baseline
cohort of patients 8 years postadmission.
Design
Retrospective review and prospective repeated measures of an inception cohort.
Setting
Polytrauma rehabilitation center (PRC).
Participants
Patients consecutively admitted to the PRC inpatient rehabilitation unit during its
first full fiscal year, 2006 (N=44).
Interventions
The PRC infrastructure and formalized rehabilitation for polytrauma/TBI.
Main Outcome Measures
FIM scores at admission, discharge, 3 months, and 8 years postdischarge; participation-related
socioeconomic factors reflecting community reintegration 8 years after admission.
Results
Functional gains were statistically significantly increased from admission to discharge.
Improvements were maintained at both 3 months postdischarge and 8 years postdischarge.
The socioeconomic data collected at 8-year follow-up showed >50% either competitively
employed or continuing their education and 100% living in a noninstitutionalized setting.
Conclusions
This study addresses a concern regarding the long-term functional outcomes of rehabilitation
patients treated by the established infrastructure of the Polytrauma System of Care
inpatient rehabilitation centers. The results suggest that polytrauma/TBI rehabilitation
care using a comprehensive, integrated approach is effective and durable in achieving
functional gains and successful community reintegration within our initial PRC cohort.
Follow-up of subsequent fiscal year cohorts would add to the validity of these outcome
findings.
Keywords
List of abbreviations:
FY (fiscal year), PRC (polytrauma rehabilitation center), PSC (Polytrauma System of Care), TBI (traumatic brain injury), VA (Department of Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 30, 2017
Footnotes
Supported by the Veterans Affairs Palo Alto Health Care System and the Department of Veterans Affairs Central Office leadership.
The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense, or any other federal agency, position, policy, or decision unless so designated by other official documentation.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
