Rehabilitation outcome following traumatic brain injury - the Singapore experience

The objectives of this study were to define (1) demographic and injury char acteristics for acute traumatic brain injury (TBI) patients admitted to reh abilitation; (2) admission and discharge functional status; (3) discharge d isposition and vocation status at follow-up. The charts of 80 consecutive T BI admissions (64 males, 16 females) were reviewed. Outcome measures includ ed admission and discharge Modified Barthel Index (MBI) scores, length of r ehabilitation stay, discharge disposition and return-to-work status at 1 ye ar post-injury. Fifty-seven (71.3%) of patients were aged 40 years or less. Motor vehicle accidents accounted for 70.0% (56) of injuries. Sixty-one (7 6.3%) had severe head injuries. Diffuse cerebral oedema was present in 41.3 % (33) and 52.5% (42) had intracranial haematoma. Admission and discharge M BI scores were 49.6 +/- 33.7 and 76.9 +/- 25.6 respectively. This differenc e was significant (P < 0.001). Memory and planning/ organization deficits w ere present in 68.6% and 70.5% of patients (51 tested). Multiple regression analysis showed that admission MBI score had significant influence on disc harge functional outcome (Multiple R 0.66, R-2 0.40, P < 0.001). Seventy-tw o (90%) were discharge home and 25% (20) returned to work at 1 year post-in jury. We conclude that this cohort of TBI patients showed significant impro vement in functional status after rehabilitation, and admission functional status had the most impact on discharge functional outcome.