Outcome after traumatic brain injury: Pathway analysis of contributions from premorbid, injury severity, and recovery variables

被引:166
作者
Novack, TA [1 ]
Bush, BA [1 ]
Meythaler, JM [1 ]
Canupp, K [1 ]
机构
[1] Univ Alabama, Spain Rehabil Ctr, Dept Phys Med & Rehabil, Birmingham, AL 35233 USA
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2001年 / 82卷 / 03期
关键词
brain injuries; traumatic; treatment outcome; rehabilitation;
D O I
10.1053/apmr.2001.18222
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To examine the relationship of premorbid variables, injury severity, and cognitive and functional status to outcome 1 year after traumatic brain injury (TBI) and to assess the feasibility of multivariate path analysis as a way to discover those relationships. Design: Prospective, longitudinal. Settings: Level I trauma center, acute inpatient rehabilitation hospital. Patients: One hundred seven subjects (87 men, 20 women; mean age, 33.91 +/- 14.2 yr) who had experienced severe TBI, typically from motor vehicle crashes. Interventions: Acute medical and rehabilitation care. Main Outcome Measures: Disability Rating Scale, Community Integration Questionnaire, and return to employment. Evaluated in acute rehabilitation, and at 6 and 12 months' postinjury. Results: Path analyses revealed that premorbid factors had significant relationships with injury severity, functional skills, cognitive status, and outcome; injury severity affected cognitive and functional skills; and cognitive status influenced outcome. No significant relationships were found between injury severity and emotional status, injury severity and outcome, emotional status and outcome, and functional skills and outcome. Conclusions: Multivariate analysis is important to understanding outcome after TBI. Injury severity, as measured in this study, is less important to 12-month outcome than the premorbid status of the person and the difficulties (particularly cognitive deficits) exhibited at follow-up 6 months after the trauma.
引用
收藏
页码:300 / 305
页数:6
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