1545 - Examining the Differences in Functional Outcomes for Patients with Traumatic Brain Injury After Acute Rehabilitation and Subacute Rehabilitation: A Review of the Literature

Objectives: Traumatic brain injury (TBI) is one of the major causes of morbidity in the US. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. However, various types of inpatient rehabilitation exist, including acute rehabilitation, subacute rehabilitation, or a combination of both. The structure and outcomes of these programs are not well-delineated. The purpose of this study is to examine patient outcomes across all pathways of inpatient rehabilitation following TBI.

Design: A structured review of current literature was conducted. Articles were included if they contained the key words “post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI” AND “acute rehabilitation OR subacute rehabilitation” AND “outcomes OR functional outcomes”. Articles were limited to 1990-2023. The studies were divided into two categories: those addressing acute rehabilitation and those addressing subacute rehabilitation. Studies about pediatric populations were excluded.

Outcome measures included disability ratings, physical independence, independence with ADLs, social re-integration inside and outside of home, cognitive recovery, and general mobility.

Articles examined include meta-analyses, clinical trials, cohort studies, and other literature reviews.

Results: Ten articles addressed outcomes after acute rehabilitation, while zero articles addressed outcomes after subacute rehabilitation. The studies suggested improved functional independence with earlier and intensive rehabilitation following TBI. They also indicated improved cognition and likelihood of being discharged home with acute rehabilitation. Compared to those who were discharged from acute care to long term care, those who received rehabilitation had better FIM scores and HSQ-12 scores.

Conclusions: The current literature and evidence suggest that early intensive inpatient rehabilitation after TBI improves functional outcomes and the odds of discharge to home. Current research critically lacks information regarding outcomes after subacute rehabilitation. As trends move towards increased utilization of subacute rehabilitation services, future research must be focused on outcomes in the patient population at the subacute rehabilitation level.