Impact of clinically significant heterotopic ossification on functional outcome after traumatic brain injury

Objective: To assess heterotopic ossification's (HO) impact on functional outcome after TBI. Design: Retrospective with matched control group, single center. Setting: TBI Model System of Care at the Medical College of Virginia of Virginia Commonwealth University, Richmond, VA. Participants: Twenty-six patients with TBI and triple-phase bone scan confirmed HO were matched with 26 patients without clinical evidence of HO. Main outcome measures: Acute and rehabilitation lengths of stay (LOS), Admission and Discharge Functional Independence Measure (FIM) scores, FIM change, FIM efficiency (FIM gains per week), and discharge disposition. Results: The two groups had similar acute care LOS. Patients with HO had significantly longer inpatient rehabilitation LOS and significantly lower FIM mobility and activities of daily living subscale scores on admission and discharge. FIM efficiency was significantly lower for the group with HO. Significantly fewer patients with HO were able to be discharged to home. Conclusions: HO is associated with a poorer functional outcome; however, it is not clear whether HO causes the decreased function or whether it may serve more generally as an indicator Of those patients who will not progress as far or as rapidly during inpatient rehabilitation.