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Published on: February 16, 2011
Process and outcome during early inpatient rehabilitation after brain injury
M J Edwards1, J E McNeil, R J Greenwood
1The Regional Neurological Rehabilitation Unit, Homerton Hospital, London, UK.
Insights
Early inpatient rehabilitation improved function for most young adults with brain injuries. Patient demographics and ethnic diversity did not impact outcomes, though measurement tools had limitations.
Area of Science:
- Neurorehabilitation
- Brain Injury Recovery
- Clinical Outcomes Research
Background:
- Younger adults with single incident brain injuries require specialized inpatient rehabilitation.
- Understanding rehabilitation processes and outcomes is crucial for service improvement.
Purpose of the Study:
- To describe the process and outcomes of early inpatient rehabilitation for younger adults post-brain injury.
- To analyze patient characteristics and factors influencing rehabilitation success.
Main Methods:
- Analysis of a 5-year database of 290 patients from an inner-city inpatient rehabilitation unit.
- Utilized Barthel Index and Functional Independence Measure to assess patient progress.
Main Results:
- Stable patient case-mix observed, with a majority of young males suffering traumatic brain injury.
- Most patients showed improvements in disability and dependency.
- Ethnic diversity did not affect rehabilitation outcomes; measurement tool limitations noted for 15% of patients.
Conclusions:
- Early inpatient rehabilitation leads to significant functional improvements in younger adults with brain injuries.
- Clinical indicators of dependency and outcome, along with resource utilization, characterize rehabilitation services.
- Sharing such data can drive improvements in brain injury rehabilitation delivery.
Purpose:
To describe aspects of process and outcome during early inpatient rehabilitation of younger adults after single incident brain injury.
Method:
Analysis of a database of 290 patients discharged from an inner-city hospital based inpatient unit for younger adults after single incident neurological events, over a 5-year period.
Results:
Analysis showed a stable case-mix of patients over the 5 years surveyed with a preponderance of young male patients after traumatic brain injury. Improvements in patients' disability and dependency, measured by the Barthel Index and Functional Independence Measure, were recorded in the majority of patients. The ethnic diversity of the patients, reflecting the multi-cultural nature of the catchment population, did not appear to affect rehabilitation outcome. Failure to record improvement in 15% of patients was related to the floor and ceiling effects of the instruments. A useful regression equation was produced relating length of stay to Barthel score on admission.
Conclusions:
These data demonstrate the changes that occur during early inpatient rehabilitation after single incident brain injury. They explore clinical indicators of dependency and outcome, and aspects of resource utilization that characterize our service. Publication of data of this sort, from this and other units, should encourage the development and improvement of current rehabilitation service delivery after brain injury.
