@article{ref1,
title="Volumetric analysis of day of injury computed tomography is associated with rehabilitation outcomes after traumatic brain injury",
journal="Journal of trauma and acute care surgery",
year="2016",
author="Majercik, Sarah and Bledsoe, Joseph and Ryser, David K. and Hopkins, Ramona O. and Fair, Joseph E. and Frost, R. Brock and MacDonald, Joel and Barrett, Ryan and Horn, Susan D. and Pisani, David and Bigler, Erin D. and Gardner, Scott and Stevens, Mark and Larson, Michael J.",
volume="82",
number="1",
pages="80-92",
abstract="INTRODUCTION: Day-of-injury (DOI) brain lesion volumes in traumatic brain injury (TBI) patients are rarely used to predict long-term outcomes in the acute setting. The purpose of this study was to investigate the relationship between acute brain injury lesion volume and rehabilitation outcomes in patients with TBI at a Level One Trauma Center. <br><br>METHODS: Patients with TBI who were admitted to our rehabilitation unit after the acute care trauma service from February 2009-July 2011 were eligible for the study. Demographic data and outcome variables including cognitive and motor FIM scores, length of stay (LOS) in the rehabilitation unit, and ability to return to home were obtained. DOI quantitative injury lesion volumes and degree of midline shift were obtained from day-of-injury (DOI) brain computed tomography (CT) scans. A multiple step-wise regression model including 13 independent variables was created. This model was used to predict post-rehabilitation outcomes, including FIM scores and ability to return to home. P<0.05 was considered significant. <br><br>RESULTS: 96 patients were enrolled in the study. Mean age was 43±21 years, admission Glasgow Coma Score 8.4±4.8, Injury Severity Score 24.7±9.9, and head Abbreviated Injury Scale score 3.73±0.97. Acute hospital length of stay (LOS) was 12.3±8.9 days and rehabilitation LOS was 15.9±9.3 days. Day-of-injury TBI lesion volumes were inversely associated with cognitive FIM scores at rehabilitation admission (p=0.004) and discharge (p=0.004) and inversely associated with ability to be discharged to home after rehabilitation (p=0.006). <br><br>CONCLUSION: In a cohort of patients with moderate to severe TBI requiring a rehabilitation unit stay after the acute care hospital stay, DOI brain injury lesion volumes are associated with worse cognitive FIM scores at the time of rehabilitation admission and discharge. Smaller injury volumes were associated with eventual discharge to home. Volumetric neuroimaging in the acute injury phase may improve surgeons' ultimate outcome predictions in TBI patients.Level of Evidence/Study TypeLevel V, case series, Prognostic/Epidemiological.<p /> <p>Language: en</p>",
language="en",
issn="2163-0755",
doi="10.1097/TA.0000000000001263",
url="http://dx.doi.org/10.1097/TA.0000000000001263"
}