Recovery and rehabilitation following traumatic brain injury

Although most patients are discharged following traumatic brain injury (TBI) with "good recovery', recent reports indicate that many have persistent neuropsychological deficits. The purposes of this study were to: (1) determine if functional, neuropsychological and social outcome at 3 and 6 months in patients hospitalized following TBI could be ascertained via telephone follow-up, and (2) assess use of rehabilitation services in this population. Patients were identified through acute hospital admissions. A trained nurse practitioner abstracted data from acute charts. Using the Functional Independence Measure (FIM), Neurobehavioral Rating Scale (NRS), Telephone Interview for Cognitive Status (TICS), and a social questionnaire she obtained follow-up information at 3 and 6 months post-injury. Of 74 patients initially identified, 51 and 48 were available at 3 and 6 months, respectively. Most experienced mild to moderate TBI. Physical disability was minimal at follow-up as indicated by the FIM. Approximately half of the patients were rated cognitively impaired on the TICS at 3 months and over one-third remained impaired at 6 months. At 6 months 60.5% remained unemployed. Only eight of the 67 discharged survivors received any rehabilitation services. A brief telephone follow-up appears to be a cost-effective way to ascertain functional and neuropsychological outcome in TBI survivors. Since few of these patients received rehabilitation, a telephone follow-up may identify those who would potentially benefit from additional rehabilitation services.