Functional independence and agitation outcomes following inpatient rehabilitation after structural brain injury: A retrospective cohort study

ABSTRACT

The study’s purpose was to analyze outcomes of patients with severe behavioural disturbances after acquired brain injury (ABI) in order to identify predictors of discharge destination from a specialized unit (SU) of a Swiss neurorehabilitation facility. Retrospective analysis of 85 patients. Potential predictors of the main outcome discharge destination were assessed with a correlation analysis. The Agitation Behaviour Scale (ABS), Functional Independence Measure (FIM), length of stay (LOS) and pre-living situation were tested in a logistic regression analysis. Twenty-nine patients were institutionalized and 56 patients went home. Discharge destination was significantly correlated to ABS score at discharge from SU (r_s= −.33, p = .002), total FIM score on admission to the SU (r_s = .25, p = .022), total FIM score at discharge from the SU (r_s= .37, p < .001), LOS at the SU (r_s= −.36, p = .001), and LOS after discharge of the SU (r_s= .36, p = .001). Multivariate analysis showed that FIM scores at discharge (OR = 1.03, p = .008), and LOS at SU (OR = 0.98, p = .017) predicted discharge destination significantly. FIM or LOS may be important predictors in planning discharge destination in patients with severe behavioural disturbances. Further prospective studies are critically needed to better understand the complexity of interactions amongst important predictive factors.

KEYWORDS:

• Acquired brain injury
• Agitation
• Neurorehabilitation
• Functional independence
• Discharge destination

Acknowledgements

The authors thank PhD. Clare Maguire for proofreading the present manuscript and the neuropsychologists of the REHAB Basel for supporting the data collection.

Author contributions

P. E.: Conceptualization, Data Collection, Data Analysis, Writing (Original Draft), Writing (Review & Editing), Project Administration, Visualization. D. I.: Conceptualization, Data Collection, Writing (Original Draft), Writing (Review & Editing), Project Administration. H. M.: Conceptualization, Writing (Original Draft), Writing (Review & Editing), Funding Acquisition.

Disclosure statement

Isabelle Debecker and Elena Pauli are co-first authors. All authors are employed by REHAB Basel from which archival data reported in this manuscript came. No party having a financial or non-financial interest in the results presented herein has or will confer a benefit to them.

Additional information

Funding

This study was supported by REHAB Basel.