TY  - JOUR
PY  - 2013//
TI  - Descriptive characteristics and rehabilitation outcomes in active duty military personnel and veterans with disorders of consciousness with combat and non-combat related brain injury
JO  - Archives of physical medicine and rehabilitation
A1  - Nakase-Richardson, Risa
A1  - McNamee, Shane
A1  - Howe, Laura L. S.
A1  - Massengale, Jill
A1  - Peterson, Michelle
A1  - Barnett, Scott D.
A1  - Harris, Odette
A1  - McCarthy, Marissa
A1  - Tran, Johanna
A1  - Scott, Steven
A1  - Cifu, David X.
SP  - 1861
EP  - 1869
VL  - 94
IS  - 10
N2  - 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>
LA  - en
SN  - 0003-9993
UR  - http://dx.doi.org/10.1016/j.apmr.2013.05.027
ID  - ref1
ER  -