Use of early indicators in rehabilitation process to predict functional outcomes in subjects with acquired brain injury

Background. The use of Evaluation Scales in ABI is necessary for measure of outcome, but not always they are used as predictor factors for rehabilitation processes and organization. Aim. The aim of this study was to evaluate the effectiveness and efficiency of an inpatient rehabilitation program for patients with traumatic brain injury through the use of selected indicators and to identify predictive factors for functional outcome. Design. This was a retrospective database analysis. Setting. Patients admitted to an Intensive Rehabilitation Unit as inpatient (Sacro Cuore-Don Calabria Hospital, Negrar-Verona). Population. The population included patients with traumatic brain injury. Methods. The study enrolled 175 patients admitted to an Intensive Rehabilitation Unit between 2004 and 2007. Data collected included demographic characteristics, first 24-hours worst GCS, length of acute and rehabilitative stay at admission and discharge FIM, DRS, LCF and GOS. Results. There was a statistically significant recovery over the course of admission for all assessment tools (P < 0.000). When patients were subdivided on the basis of admission DRS categories a linear correlation among variables could be observed, with most disabled patients showing the longest acute and rehabilitation stays and the lowest functional gains. Within each DRS category age appeared to affect improvement (P < 0.005) while final outcome was influenced not only by age but also by initial functional status (P < 0.000) and time from injury to admission (P < 0.004). Conclusions and Clinical Rehabilitation Impact. Systematic data collection in intensive rehabilitation is of great importance to monitor recovery and plan appropriate programs on the basis of admission functional status.