Effect of Preexisting and Co-Occurring Comorbid Conditions on Recovery in the 5 Years After Rehabilitation for Traumatic Brain Injury. Issue 3 (May 2020)

• Record Type: Journal Article
• Authors: Corrigan, John D.; Zheng, Tianyu; Pinto, Shanti M.; Bogner, Jennifer; Kean, Jacob; Niemeier, Janet P.; Guerrier, Tami P.; Haaland, Benjamin; Horn, Susan D.
• Is Part Of: Journal of head trauma rehabilitation. Volume 35:Issue 3(2020)
• Publication Date: 2020-05
• Subjects: comorbidities -- function -- medical conditions -- outcomes -- rehabilitation -- traumatic brain injury; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000521
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : Objective: To determine the relationship between comorbid health conditions and the trajectory of functional recovery 5 years following traumatic brain injury (TBI) rehabilitation. Setting: Two acute rehabilitation facilities. Participants: A total of 407 patients with primary diagnosis of TBI. Design: Prospective, observational. Main Measures: Functional Independence Measure Cognitive and Motor scores. Results: Female gender was negatively associated with the trajectory of motor recovery ( P < .001). TBI severity was negatively associated with both motor and cognitive recovery and interacted with time after injury (both P s < .0001). Hypertension was negatively associated with both motor ( P < .0001) and cognitive ( P = .0121) recovery, although this relationship diminished over time for motor function ( P = .0447). Cardiac conditions were negatively associated with motor recovery ( P = .0204), and rate of cognitive recovery was more rapid for patients with cardiac conditions ( P = .0088). Depressed patients recovered cognitive function more quickly than those who were not depressed ( P = .0196). Diabetes was negatively associated with motor function ( P = .0088). Drug/alcohol use was positively associated with motor function ( P = .0036). Conclusions: Injury severity remains an important predictor of long-term recovery; however, certain comorbid medical conditions are negatively associated with functional abilities over the first 5 years after injury. Patients being discharged from TBI rehabilitation with comorbid cardiac, hypertensive, diabetic, and/or depressive conditions may benefit from early and ongoing clinical surveillance.