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Titre : | Descriptive Characteristics and Rehabilitation Outcomes in Active Duty Military Personnel and Veterans With Disorders of Consciousness With Combat- and Noncombat-Related Brain Injury (2013) |
Auteurs : | Risa Nakase-Richardson ; Shane McNamee ; Laura L. Howe ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2013/10, 2013) |
Article en page(s) : | pp. 1861-1869 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Évaluation de résultat (soins) ; Rééducation et réadaptation |
Mots-clés: | Brain Injuries ; Lésions encéphaliques ; Consciousness Disorders ; Troubles de la conscience ; Executive Function ; Fonctions exécutives ; Outcome Assessment (Health Care) |
Résumé : |
Objective To report the injury and demographic characteristics, medical course, and rehabilitation outcome for a consecutive series of veterans and active duty military personnel with combat- and noncombat-related brain injury and disorder of consciousness (DOC) at the time of rehabilitation admission. Design Retrospective study. Setting Rehabilitation center. Participants From January 2004 to October 2009, persons (N=1654) were admitted to the Polytrauma Rehabilitation System of Care. This study focused on the N=122 persons admitted with a DOC. Participants with a DOC were primarily men (96%), on active duty (82%), ≥12 years of education, and a median age of 25. Brain injury etiologies included mixed blast trauma (24%), penetrating (8%), other trauma (56%), and nontrauma (13%). Median initial Glasgow Coma Scale score was 3, and rehabilitation admission Glasgow Coma Scale score was 8. Individuals were admitted for acute neurorehabilitation approximately 51 days postinjury with a median rehabilitation length of stay of 132 days. Interventions None. Main Outcome Measures Recovery of consciousness and the FIM instrument. Results Most participants emerged to regain consciousness during neurorehabilitation (64%). Average gains + SD on the FIM cognitive and motor subscales were 19+25 and 7+8, respectively. Common medical complications included spasticity (70%), dysautonomia (34%), seizure occurrence (30%), and intracranial infection (22%). Differential outcomes were observed across etiologies, particularly for those with blast-related brain injury etiology. Conclusions Despite complex comorbidities, optimistic outcomes were observed. Individuals with severe head injury because of blast-related etiologies have different outcomes and comorbidities observed. Health-services research with a focus on prevention of comorbidities is needed to inform optimal models of care, particularly for combat injured soldiers with blast-related injuries. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |