@article{ref1,
title="Descriptive characteristics and rehabilitation outcomes in active duty military personnel and veterans with disorders of consciousness with combat and non-combat related brain injury",
journal="Archives of physical medicine and rehabilitation",
year="2013",
author="Nakase-Richardson, Risa and McNamee, Shane and Howe, Laura L. S. and Massengale, Jill and Peterson, Michelle and Barnett, Scott D. and Harris, Odette and McCarthy, Marissa and Tran, Johanna and Scott, Steven and Cifu, David X.",
volume="94",
number="10",
pages="1861-1869",
abstract="OBJECTIVE: To report the injury and demographic characteristics, medical course, and rehabilitation outcome for a consecutive series of veterans and active duty military personnel with combat and non-combat related brain injury and disorder of consciousness at time of rehabilitation admission. DESIGN: Retrospective Study. SETTING: VHA Polytrauma Rehabilitation Center's Emerging Consciousness Program (ECP). PARTICIPANTS: From Janauary of 2004 to October of 2009, N=1654 persons were admitted to the Polytrauma Rehabilitation System of Care. This study focused on the N=122 persons admitted with a disorder of consciousness (DOC). Participants with DOC were primarily male (96%), active duty (82%), with ≥ 12 years of education, and a median age of 25. Brain injury etiologies included mixed blast trauma (24%), penetrating (8%), other trauma (56%), and nontrauma (13%). Median initial GCS was 3 and rehabilitation admission GCS was 8. Individuals were admitted for acute neurorehabilitation approximately 51 days post injury with a median rehabilitation length of stay of 132 days. INTERVENTION: None MAIN OUTCOME MEASURES: Recovery of consciousness. Functional Independence Measure. RESULTS: A majority of participants emerged to regain consciousness during neurorehabilitation (64%). Average gains on the Functional Independence Measure Cognitive and Motor subscales were 19 (SD 25) and 7 (SD 8) respectively. Common medical complications included spasticity (70%), dysautonomia (34%), seizure occurrence (30%), and intracranial infection (22%). Differential outcomes were observed across etiologies particularly for those with blast-related brain-injury etiology. CONCLUSION: Despite complex comorbidities, optimistic outcomes were observed. Individuals with severe head injury due to blast-related etiologies have different oucomes and comorbidities observed. Health-services research with a focus on prevention of comorbidities is needed to inform optimal models of care particularly for combat-injured soldiers with blast-related injuries.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2013.05.027",
url="http://dx.doi.org/10.1016/j.apmr.2013.05.027"
}