Short Title:Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):16, 97, 11, 1821-1831
Study compared patient functional outcomes across Traumatic Brain Injury Model Systems (TBIMS) rehabilitation centers and identified sociodemographic, clinical, and injury characteristics that influenced patient those outcomes. Data were analyzed for 5,505 patients with traumatic brain injury (TBI) admitted to 19 TBIMS rehabilitation centers over a 10-year period (2003-2012). Functional outcomes were measured using the Disability Rating Scale and the Functional Independence Measure at discharge and at the 1-year follow-up. Individuals with lower functional status at the time of admission, longer duration of posttraumatic amnesia, and higher burden of medical comorbidities continued to have worse functional outcomes at discharge from inpatient rehabilitation and at the 1-year follow-up, whereas those who were employed at the time of injury had better outcomes at both time periods. Risk-adjusted patient functional outcomes for patients in most TBIMS centers were consistent with previous research. However, there were wide performance differences for a few centers even after using more recently collected data, improving on the regression models by adding predictors known to influence functional outcomes, and using bootstrapping to eliminate confounds. Specific patient, injury, and clinical factors are associated with differences in functional outcomes within and across TBIMS rehabilitation centers. However, these factors did not explain all the variance in TBI patient outcomes, suggesting a role of some other predictors that remain unknown.