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Change in functional outcomes during inpatient rehabilitation for patients with hypoxic-ischemic brain injury

Arch Phys Med Rehabil 96:e18.

Toronto Rehabilitation Institute, Toronto, ON, Canada

Objective(s): To investigate determinants of change in functional outcomes during inpatient rehabilitation (IR) among hypoxic-lschemic brain injury (HIBi) patients.

Design: Population-based prospective cohort.

Setting: Ontario, Canada.

Participants: All patients aged 20 years and older with a HIBi entering IR,  with an admitting HIBi diagnosis, treated for non-traumatic acquired brain  injury (nTBI) from 2002 through 2012. HIBi cases were identified using  International Classification of Diseases Version 10 and equivalent diagnostic  codes. Admissions allocated for nTBI-specific rehabilitation were  identified. Total participants: N = 291.

Interventions: N/ A.

Main Outcome Measure(s): Change in total and cognitive Functional Independence Measure (FIM) summary indices.

Results: There were 291 HIBi patients treated for nTBI with a HIBIassociated  diagnosis in IR, 89% of whom had anoxic encephalopathy  (ICD-10: G93. l). The majority (89%) were referred from acute care. Mean  total FIM scores at admission and discharge were 80.6 (SD=29.2) and  97.5 (SD=27.9), respectively. Mean cognitive FIM scores at admission  and discharge for this group were 20.8 (SD=7.3) and 24.3 (SD=7.4),  respectively. Mean changes in total (16.9; SD= 15.5) and cognitive (3.51;  SD=4.26) summary FIM scores were statistically significant (p< 0.001).  Multivariable regression among those with anoxic encephalopathy  (n=259) suggested that total FIM score increased among those aged 50-79  years (age 65-79 vs

Conclusions: That functional outcomes improved more drastically for  older middle-aged patients, those living in regions of lowest SES relative  to highest and those living in rural areas, suggest HIBi patients are a  unique IR population, with specific care needs, warranting further inquiry.