Factors associated with self-awareness impairment in an inpatient brain injury rehabilitation cohort

Figures & data

Table 1. Participant demographics and diagnostic information: N(%) or m(SD); median(IQR).

	TBI (n = 110)	Stroke (n = 39)
Gender: Male	83 (75%)	25 (64%)
Age (years)	43 (15); 42 (24)	50 (13); 48 (18)
Brain injury severity:
Stroke – GCS score*	-	7 (5); 7 (10)
TBI – PTA duration** (days)	59 (42); 52 (47)	-
Moderate (1–7 days)	n = 2(2%)	-
Severe (1–4 weeks)	n = 22(20%)	-
Very severe (>4 weeks)	n = 84(76%)	-
LOS (acute)	41 (34); 31 (37)	41 (34); 30 (37)
LOS (total hospital admission)	163 (128); 120 (161)	202 (126); 120 (157)
Premorbid mental health diagnosis, number yes (%)	29 (26%)	6 (15%)
Premorbid drug/alcohol history, number yes (%)	39 (35%)	11 (28%)
Behaviors of concern during hospitalisation, number yes (%)	47 (43%)	12 (31%)
Disorder of consciousness duration (days)	58 (26); 47 (32)	60 (41); 34 (36)
Functional Independence
FIM total score (possible scores 18–126)	42 (28); 30 (42)	51 (31); 48 (62)
FIM cognition/comm (possible scores 5–35)	13 (9); 10 (12)	16 (9); 17 (16)
FIM motor (possible scores 13–91)	31 (23); 17 (36)	36 (26); 26 (46)
SMAF disability total (possible scores 0 to −87)	−60 (19); −64 (31)	−55 (18); −58 (33)
SMAF IADL score	−22 (4); −24 (3)	−24 (11); −24 (5)
Time post-ABI onset SADI completed (days)	100 (73); 79 (74)	97 (70); 79 (73)
SADI total score M (SD)	5.1 (2.6)	4.4 (2.6)
SADI score ranges: N (%):
No impairment (score 0–1)	15 (14%)	4 (10%)
Mild impairment (score 2–3)	16 (15%)	10 (26%)
Moderate impairment (score 4–6)	39 (35%)	15 (38%)
Severe impairment (score 7–9)	40 (36%)	10 (26%)
Employment status at time of ABI:
Employed	64 (58%)	25 (64%)
Unemployed	34 (31%)	9 (23%)
Retired	8 (7%)	4 (10%)
Student	4 (4%)	1 (3%)
Premorbid living arrangements:
Home with family/others	80 (73%)	25 (64%)
Home alone	22 (20%)	12 (31%)
Homeless	7 (6%)	1 (2%)
Supported accommodation	1 (1%)	1 (2%)
Cause of TBI:
MVA	35 (32%)	-
MBA	7 (6%)	-
Bike Vs car	3 (3%)	-
Pedestrian	6 (6%)	-
Fall	41 (37%)	-
Assault	11 (10%)	-
Other†	6 (6%)
Stroke type:
Ischaemic stroke	-	18 (46%)
Haemorrhagic stroke	-	21 (54%)
Cortical stroke	-	31 (79%)
Subcortical stroke	-	8 (21%)
Stroke location:
Right	-	19 (49%)
Left	-	13 (34%)
Bilateral	-	7 (18%)

†Other = quadbike, tractor and horse; *Missing data for n = 8 (stroke); **Missing data for n = 2 (TBI); Abbreviations: GCS = Glasgow Coma Scale, PTA = post-traumatic amnesia, LOS = length of stay, FIM = Functional Independence Measure, SMAF = Functional Autonomy Measure, IADL = Instrumental Activities of Daily Living, SADI = Self-awareness of Deficits Interview.

Table 2. Spearman’s rho correlations between SADI scores and continuous variables.

Variable	SADI score
	TBI		Stroke
	r^s	p	r^s	p
Age	.015	.873	.115	−.377
PTA duration	.320	<.001*	-	-
LOS (acute)	.085	.377	.246	.131
Admission FIM -cognition/communication	−.208	.030*	−.533	<.001*
Admission FIM – motor	−.091	.349	−.377	.023*
Admission FIM – total	−.138	.153	−.398	.016*
Admission SMAF – total	−.105	.276	−.224	.177
Admission SMAF – IADL	−.163	.107	−.273	.144

*p < 0.05. Abbreviations: PTA = post-traumatic amnesia, LOS = length of stay, FIM = Functional Independence Measure, SMAF = Functional Autonomy Measure, IADL = Instrumental activities of daily living.

Table 3. Mann-Whitney U comparisons of SADI score for dichotomous variables.

Variable	SADI score
	TBI	Stroke
	Mann-Whitney U (p)	Mann-Whitney U (p)
Gender (male, female)	901.5 (.126)	205.5 (.377)
BoC (present, absent)	1004.0 (.004*)	89 (.026*)
Mental health comorbidities (present, absent)	1221.0 (.751)	100.0 (1.000)
Drug/alcohol history (present, absent)	1325.5 (.711)	99.0 (.089)

*p < 0.05.Abbreviations: BoC = behaviors of concern.

Table 4. Ordinal regression model examining associations between predictor variables and SADI scores: TBI group (n = 110).

					95% confidence interval
	Estimate	Std error	Wald	Sig	Lower bound	Upper bound
PTA duration	.028	.009	9.667	.002*	1.010	1.046
FIM cognition/communication	−.008	.022	.127	.722	.949	1.037
FIM motor	.002	.010	.068	.794	.984	1.021
LOS (acute)	−.025	.010	6.285	.012*	.957	.995
BoC	.776	.403	3.710	.054	.987	4.781

*p < 0.05.Abbreviations: PTA = post-traumatic amnesia, FIM = Functional Independence Measure, LOS = length of stay, BoC = behaviors of concern.

Table 5. Ordinal regression model examining associations between predictor variables and SADI scores: Stroke group (n = 39).

					95% confidence interval
	Estimate	Std error	Wald	Sig	Lower bound	Upper bound
LOS (acute)	.001	.712	.015	.901	.980	1.023
FIM cognition/communication	−.131	.054	5.915	.015*	.789	.975
FIM motor	.007	.015	.211	.646	.977	1.038
BoC	.787	.712	1.222	.269	.544	8.877

*p < 0.05.LOS = length of stay, FIM = Functional Independence Measure, BoC = behaviors of concern.

Bogod N, Mateer C, Macdonald S. Self-awareness after traumatic brain injury: a comparison of measures and their relationship to executive functions. J Int Neuropsychol Soc. 2003;9(3):450–58. doi:10.1017/S1355617703930104.

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