Recovery and rehabilitation following traumatic brain injury.

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Abstract
Although most patients are discharged following traumatic brain injury (TBI) with "good recovery', recent reports indicate that many have persistent neuropsychological deficits. The purposes of this study were to: (1) determine if functional, neuropsychological and social outcome at 3 and 6 months in patients hospitalized following TBI could be ascertained via telephone follow-up, and (2) assess use of rehabilitation services in this population. Patients were identified through acute hospital admissions. A trained nurse practitioner abstracted data from acute charts. Using the Functional Independence Measure (FIM), Neurobehavioral Rating Scale (NRS), Telephone Interview for Cognitive Status (TICS), and a social questionnaire she obtained follow-up information at 3 and 6 months post-injury. Of 74 patients initially identified, 51 and 48 were available at 3 and 6 months, respectively. Most experienced mild to moderate TBI. Physical disability was minimal at follow-up as indicated by the FIM. Approximately half of the patients were rated cognitively impaired on the TICS at 3 months and over one-third remained impaired at 6 months. At 6 months 60.5% remained unemployed. Only eight of the 67 discharged survivors received any rehabilitation services. A brief telephone follow-up appears to be a cost-effective way to ascertain functional and neuropsychological outcome in TBI survivors. Since few of these patients received rehabilitation, a telephone follow-up may identify those who would potentially benefit from additional rehabilitation services.

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