Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: a pilot study.
Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: a pilot study.
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DOI：
10.1097/htr.0b013e31824da031
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Slomine BS
中科院分区：
文献类型：
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作者：
Kramer ME;Suskauer SJ;Christensen JR;DeMatt EJ;Trovato MK;Salorio CF;Slomine BS
在一个试点队列中，研究与功能技能水平最低的严重创伤性脑损伤（TBI）儿童出院时和出院后3个月随访的功能结局相关的因素。39名儿童和青少年（3至18岁），他们患有严重TBI，在康复入院时儿童功能独立性测量（Weekly总分= 18）的评分最低。对作为常规临床护理一部分收集的数据进行回顾性审查。出院时，59%的儿童部分依赖于基本活动，而41%的儿童仍然依赖于基本活动。最初的格拉斯哥昏迷量表评分、遵从命令的时间、受伤至康复入院的时间与出院时的功能状态相关。遵循指令的时间和从受伤到康复入院的时间与三个月随访时的功能状态相关。入院前几周功能状态的变化与出院和随访时的功能状态相关。即使是脑损伤最严重的儿童，进入康复期后，所有日常活动都完全依赖，在出院前和接下来的几个月里，他们的功能也有可能得到显著改善。在康复过程的早期评估功能状态有助于预测严重TBI的结果。
To examine in a pilot cohort factors associated with functional outcome at discharge and three-month follow-up following discharge from inpatient rehabilitation in children with severe traumatic brain injury (TBI) who entered rehabilitation with the lowest level of functional skills. 39 children and adolescents (3 to 18 years) who sustained a severe TBI and had the lowest possible rating at rehabilitation admission on the Functional Independence Measure for Children (WeeFIM total score = 18). Retrospective review of data collected as part of routine clinical care. At discharge, 59% of the children were partially dependent for basic activities while 41% remained dependent for basic activities. Initial Glasgow Coma Scale score, time to follow commands, and time from injury to rehabilitation admission were correlated with functional status at discharge. Time to follow commands and time from injury to rehabilitation admission were correlated with functional status at three-month follow-up. Changes in functional status during the first few weeks of admission were associated with functional status at discharge and follow-up. Even children with the most severe brain injuries, who enter rehabilitation completely dependent for all daily activities, have the potential to make significant gains in functioning by discharge and in the following few months. Assessment of functional status early in the course of rehabilitation contributes to the ability to predict outcome from severe TBI.