Susan D Horn1, John D Corrigan2, Jennifer Bogner2, Flora M Hammond3, Ronald T Seel4, Randall J Smout5, Ryan S Barrett5, Marcel P Dijkers6, Gale G Whiteneck7. 1. Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT. Electronic address: susan.horn@hsc.utah.edu. 2. Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH. 3. Carolinas Rehabilitation, Charlotte, NC; Indiana University School of Medicine, Indianapolis, IN. 4. Crawford Research Institute, Shepherd Center, Atlanta, GA. 5. Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT. 6. Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. 7. Research Department, Craig Hospital, Englewood, CO.
Abstract
OBJECTIVES: To describe study design, patients, centers, treatments, and outcomes of a traumatic brain injury (TBI) practice-based evidence (PBE) study and to evaluate the generalizability of the findings to the U.S. TBI inpatient rehabilitation population. DESIGN: Prospective, longitudinal, observational study. SETTING: Ten inpatient rehabilitation centers. PARTICIPANTS: Patients (N=2130) enrolled between October 2008 and September 2011 and admitted for inpatient rehabilitation after an index TBI injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Return to acute care during rehabilitation, rehabilitation length of stay, FIM at discharge, residence at discharge, and 9 months postdischarge rehospitalization, FIM, participation, and subjective well-being. RESULTS: The level of admission FIM cognitive score was found to create relatively homogeneous subgroups for the subsequent analysis of best treatment combinations. There were significant differences in patient and injury characteristics, treatments, rehabilitation course, and outcomes by admission FIM cognitive subgroups. TBI-PBE study patients were overall similar to U.S. national TBI inpatient rehabilitation populations. CONCLUSIONS: This TBI-PBE study succeeded in capturing naturally occurring variation in patients and treatments, offering opportunities to study best treatments for specific patient impairments. Subsequent articles in this issue report differences between patients and treatments and associations with outcomes in greater detail.
OBJECTIVES: To describe study design, patients, centers, treatments, and outcomes of a traumatic brain injury (TBI) practice-based evidence (PBE) study and to evaluate the generalizability of the findings to the U.S. TBI inpatient rehabilitation population. DESIGN: Prospective, longitudinal, observational study. SETTING: Ten inpatient rehabilitation centers. PARTICIPANTS: Patients (N=2130) enrolled between October 2008 and September 2011 and admitted for inpatient rehabilitation after an index TBI injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Return to acute care during rehabilitation, rehabilitation length of stay, FIM at discharge, residence at discharge, and 9 months postdischarge rehospitalization, FIM, participation, and subjective well-being. RESULTS: The level of admission FIM cognitive score was found to create relatively homogeneous subgroups for the subsequent analysis of best treatment combinations. There were significant differences in patient and injury characteristics, treatments, rehabilitation course, and outcomes by admission FIM cognitive subgroups. TBI-PBE study patients were overall similar to U.S. national TBI inpatient rehabilitation populations. CONCLUSIONS: This TBI-PBE study succeeded in capturing naturally occurring variation in patients and treatments, offering opportunities to study best treatments for specific patient impairments. Subsequent articles in this issue report differences between patients and treatments and associations with outcomes in greater detail.
Authors: R F Averill; T E McGuire; B E Manning; D A Fowler; S D Horn; P S Dickson; M J Coye; D L Knowlton; J A Bender Journal: Health Serv Res Date: 1992-12 Impact factor: 3.402
Authors: Jarrad H Van Stan; Marcel P Dijkers; John Whyte; Tessa Hart; Lyn S Turkstra; Jeanne M Zanca; Christine Chen Journal: Arch Phys Med Rehabil Date: 2018-09-27 Impact factor: 3.966
Authors: Helmut Trimmel; Marek Majdan; Andrea Wodak; Guenther Herzer; Daniel Csomor; Alexandra Brazinova Journal: Wien Klin Wochenschr Date: 2017-07-27 Impact factor: 1.704
Authors: Ronald T Seel; John D Corrigan; Marcel P Dijkers; Ryan S Barrett; Jennifer Bogner; Randall J Smout; William Garmoe; Susan D Horn Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: Flora M Hammond; Susan D Horn; Randall J Smout; Cynthia L Beaulieu; Ryan S Barrett; David K Ryser; Teri Sommerfeld Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: Susan D Horn; Merin Kinikini; Linda W Moore; Flora M Hammond; Murray E Brandstater; Randall J Smout; Ryan S Barrett Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: Susan D Horn; John D Corrigan; Cynthia L Beaulieu; Jennifer Bogner; Ryan S Barrett; Clare G Giuffrida; David K Ryser; Kelli Cooper; Deborah M Carroll; Daniel Deutscher Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: Flora M Hammond; Susan D Horn; Randall J Smout; Ronald T Seel; Cynthia L Beaulieu; John D Corrigan; Ryan S Barrett; Nora Cullen; Teri Sommerfeld; Murray E Brandstater Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: John D Corrigan; Susan D Horn; Ryan S Barrett; Randall J Smout; Jennifer Bogner; Flora M Hammond; Murray E Brandstater; Sarah Majercik Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: Kayla M Frodsham; Joseph E Fair; R Brock Frost; Ramona O Hopkins; Erin D Bigler; Sarah Majercik; Joseph Bledsoe; David Ryser; Joel MacDonald; Ryan Barrett; Susan D Horn; David Pisani; Mark Stevens; Michael J Larson Journal: Am J Phys Med Rehabil Date: 2020-09 Impact factor: 3.412