Impact of length of stay on functional outcomes of TBI patients

Michael L. Hawkins, F. D. Lewis, R. S. Medeiros

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

The purpose of this study was to compare the functional outcomes of two groups of patients with traumatic brain injury (TBI) with attention to the impact of reduced length of stay (LOS) in the trauma center (TC) and rehabilitation hospital (RH). From 1991 to 1994, 55 patients, Group 1, with serious TBI (Abbreviated Injury Scale score ≥3) were admitted to a level 1 TC and subsequently transferred to a comprehensive inpatient RH. These results have been previously published. From 1996 to 2002, 64 similarly injured patients, Group 2, received inpatient care at the same TC and RH. These patients had a marked decrease in length of stay. Functional Independence Measures (FIM) were obtained at admission (Adm), discharge (D/C), and at 1 year follow-up for both groups. The average length of stay at the TC dropped from 36 days in Group 1 to 26 days in Group 2. In addition, the average length of stay at the RH dropped from 46 days (Group 1) to 25 days (Group 2); overall, an average reduction of 31 days of inpatient care. Group 2 had significantly lower FIM scores at the time of RH discharge for self-care, locomotion, and mobility compared to Group 1. At the 1 year follow-up, however, there were no significant differences between Groups 1 and 2 in these FIM scores. FIM scores at 1 year were higher in Group 2 for communication (90% vs 71%) and social cognition (77% vs 49%) compared to Group 1. Over one-fourth of each group returned to work by the 1 year follow-up. Socially disruptive behavior occurred at least weekly in 28 per cent (Group 1) and 23 per cent (Group 2) of patients. The outcome for serious TBI is better than generally perceived. Reduction of inpatient LOS did not adversely affect the ultimate functional outcome. The decreased LOS placed a greater demand on outpatient rehabilitative services as well as a greater burden on the family of the brain-injured patient.

Original languageEnglish (US)
Pages (from-to)920-929
Number of pages10
JournalAmerican Surgeon
Volume71
Issue number11
StatePublished - Dec 1 2005

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Length of Stay
Trauma Centers
Rehabilitation
Inpatients
Abbreviated Injury Scale
Locomotion
Ambulatory Care
Self Care
Cognition
Traumatic Brain Injury
Communication
Brain

ASJC Scopus subject areas

  • Surgery

Cite this

Hawkins, M. L., Lewis, F. D., & Medeiros, R. S. (2005). Impact of length of stay on functional outcomes of TBI patients. American Surgeon, 71(11), 920-929.

Impact of length of stay on functional outcomes of TBI patients. / Hawkins, Michael L.; Lewis, F. D.; Medeiros, R. S.

In: American Surgeon, Vol. 71, No. 11, 01.12.2005, p. 920-929.

Research output: Contribution to journalArticle

Hawkins, ML, Lewis, FD & Medeiros, RS 2005, 'Impact of length of stay on functional outcomes of TBI patients', American Surgeon, vol. 71, no. 11, pp. 920-929.
Hawkins ML, Lewis FD, Medeiros RS. Impact of length of stay on functional outcomes of TBI patients. American Surgeon. 2005 Dec 1;71(11):920-929.
Hawkins, Michael L. ; Lewis, F. D. ; Medeiros, R. S. / Impact of length of stay on functional outcomes of TBI patients. In: American Surgeon. 2005 ; Vol. 71, No. 11. pp. 920-929.
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