Prudvish Yarlagadda, (2020) Functional outcomes of patients with moderate / severe traumatic brain injury 1 to 5 years following inpatient rehabilitation. Masters thesis, Christian Medical College, Vellore.
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Abstract
AIM AND OBJECTIVES: To study the functional outcome of patients with moderate / severe traumatic brain injury 1 to 5 years following inpatient rehabilitation, to compare these with outcomes at discharge and to study association of outcome with severity of injury, age, comorbidities, care pathways and duration of rehabilitation. METHODS: Functional outcome of 31 patients with TBI 1-5 years after rehabilitation was studied during review/ home visits using Disability Rating Scale, Glasgow Outcome Scale Extended and Modified Barthel Index after informed consent. Current medical conditions, vocational status and ambulatory status were noted by primary investigator using a questionnaire. Community integration questionnaire was used to measure integration into home, community and productivity. These were compared with outcome scores at discharge, duration of rehabilitation, severity of initial injury and care pathways and was statistically analysed. RESULTS: Significant improvement was seen in the outcome at follow up compared to discharge. (GOSE mean +/- SD change 0.54 +/- 1.17 with P value 0.015, DRS mean change +/- SD5.55 +/- 4.77 with Pvalue 0.000 and MBI mean change 20.464 with P value 0.000) Total mean CIQ score was 7.59 +/- 8.11(home integration: 2.31, social integration:3.24 and productivity: 2.03). 40% of the patients returned to either the same or a different job or education. 60% patients were walking independently/ with minimum assistance. 32% were walking with moderate/ maximum assistance. 8% were wheelchair dependent. Correlation of outcome at follow up was seen with severity of injury, but was not statistically significant. CONCLUSION: On long term follow up after rehabilitation, TBI patients continue to have disability. Significant improvement occurred in functional status as well as ADL independence. 37.9% patients had mild or partial disability on the DRS score while others had greater disability to varying degrees. Almost half of them (51.6%) were independent or needed minimal / moderate assistance while 48.3% continued to be in severely disabled and vegetative state. Community integration was poor indicating need to develop vocational and community rehabilitation services . Outcomes correlated with severity of injury though not statistically significant.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201729053 |
| Uncontrolled Keywords: | Traumatic brain injury, long term , outcomes, employment, GOSE, DRS, MBI, CIQ, Rehabilitation, functional. |
| Subjects: | MEDICAL > Physical Medicine and Rehabilitation |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 18:16 |
| Last Modified: | 04 Feb 2021 18:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13853 |
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