@article{ref1,
title="Early recovery following traumatic brain injury and alcohol withdrawal management",
journal="Rehabilitation psychology",
year="2018",
author="Klyce, Daniel W. and Graham, Kristin M. and Lacey, Russell W. and Carter, William E.",
volume="63",
number="4",
pages="588-594",
abstract="PURPOSE: To compare recovery experienced during inpatient rehabilitation among individuals with traumatic brain injury (TBI) based on whether their acute care included the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) protocol. <br><br>DESIGN: Participants included 234 individuals with TBI who completed inpatient rehabilitation at a TBI Model Systems site. Of these, 67 patients were treated using the CIWA protocol (TBI + CIWA); 167 patients were treated for TBI alone (TBI only). Demographic, injury, and treatment variables between the 2 groups were compared. A repeated-measures analysis of variance (ANOVA) compared Disability Rating Scale (DRS) scores between the groups at admission and discharge from inpatient rehabilitation. <br><br>RESULTS: The 2 groups did not significantly differ on DRS scores at admission to inpatient rehabilitation: TBI + CIWA, <i>M</i> = 9.6 (SD = 3.5) vs. TBI only, <i>M</i> = 10.1 <i>(SD</i> = 4.2). There was a significant difference in DRS scores at discharge, with the TBI + CIWA group having lower scores: TBI + CIWA, <i>M</i> = 6.4 (<i>SD</i> = 1.9) vs. TBI only, <i>M</i> = 7.0 (SD = 2.2). A repeated-measures ANOVA of DRS scores from admission to discharge revealed a significant between-subjects effect based on patients' Mississippi categorization of posttraumatic amnesia (PTA) duration (<i>p</i> <.001) and age (<i>p</i> =.016) but not based on their CIWA status (<i>p</i> =.068). A post hoc comparison including age as a covariate revealed a significant difference based on CIWA status (<i>p</i> =.013) within the &quot;moderate&quot; injury group at discharge, with the TBI + CIWA group having lower discharge DRS scores. <br><br>CONCLUSIONS: Given the significant symptom overlap between alcohol withdrawal and PTA, it is likely that these 2 delirium presentations are confounded during the initial recovery from TBI, leading to &quot;overestimation&quot; of injury severity-particularly among individuals with moderate TBI. (PsycINFO Database Record<br><br>(c) 2018 APA, all rights reserved).<p /> <p>Language: en</p>",
language="en",
issn="0090-5550",
doi="10.1037/rep0000240",
url="http://dx.doi.org/10.1037/rep0000240"
}