Recovery from Post-Traumatic Amnesia During Inpatient Rehabilitation: A Retrospective Cohort Study

Traumatic brain injury (TBI) is a global healthcare problem, and post-traumatic amnesia (PTA) is a known predictor of long-term and societal outcomes. However, factors influencing PTA recovery during the inpatient rehabilitation phase remain underexplored, particularly in Asian populations.

To identify factors associated with PTA duration and emergence during inpatient rehabilitation and examine their impact on functional outcomes.

We conducted a retrospective, single-center cohort study over a 7-year period among patients with acute TBI who were admitted to an inpatient rehabilitation hospital. Outcomes included PTA emergence and duration, discharge Functional Independence Measure (FIM), rehabilitation length of stay, and Glasgow Outcome Scale (GOS) at ≥1 year.

A total of 100 patients were analyzed. In an adjusted Cox regression, age ≥ 55 years (Hazard Ratio [HR] 0.47) and non-infective medical complications during rehabilitation (HR 0.31) were associated with reduced likelihood of PTA emergence, while mild admission GCS (13-15; HR 4.80) and epidural hemorrhage (EDH) (HR 2.00) were associated with PTA emergence. PTA non-emergence was associated with approximately a 20-point lower discharge FIM total score (adjusted model, p < 0.001). A PTA duration of ≥90 days was associated with a lower total discharge FIM score by approximately 45 points compared with those with a PTA duration of <28 days (p < 0.001). PTA emergence was associated with better GOS at ≥1 year (odds ratio [OR] 3.92, p = 0.02).

Both acute injury characteristics and intra-rehabilitation factors were associated with PTA recovery functional outcomes. PTA emergence, beyond PTA duration, was strongly associated with discharge functional status and long-term global outcome, supporting the clinical value of PTA in prognostication, rehabilitation planning, and goal setting.