Functional outcome of low-level traumatically brain-injured admitted to an acute rehabilitation programme

A retrospective analysis of functional status at discharge, disposition, Glasgow Outcome Scale (GOS) score at 6 months and 1 year was undertaken for 23 consecutive 'low-level' traumatic brain injury victims admitted in a state of complete dependency to an acute rehabilitation programme. All patients met criteria for extremely severe traumatic brain injury, with an average Glasgow Coma Scale score of 8.7 at admission to the rehabilitation facility (an average of 44 days post-injury). All but three patients made significant functional gains during the acute rehabilitation stay. Almost half of the study patients (48%) were discharged at home while the rest went to sub-acute rehabilitation programmes. At 6 months post-injury eight (35%) met GOS criteria for 'good' outcome or 'moderate disability'. A review of clinical features, categories of functional progress, and relationships of outcome and disposition to variables known to have predictive value in such a patient population is described. Analysis of variables related to admission selection criteria that have been used in this rehabilitation programme is presented and the basis and implications of selection criteria discussed.