Clinical factors affecting good activity daily living in the intermediate care phase in moderate and severe degree traumatic brain patient in Chiangrai Province
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Abstract
Background
Patients with traumatic brain injury have a high mortality rate and disability. Intermediate rehabilitation in a community hospital is important for the first 6 months after injury. Prognostic factors influence the planning and selection of patients for the community hospital.
Objective
To investigate the Clinical factors affecting good functional outcome in the intermediate care phase after moderate and severe traumatic brain injury. And to study results of intermediate care rehabilitation in patients with traumatic brain injury.
Methods
Clinical data of patients with moderate to severe traumatic brain injury from October 2021 to December 2023 were retrospectively collected and analyzed. Based on Barthel Index score (BI) at 6 months after discharge, patients were divided into good functional outcome groups (BI > 15) and poor functional outcome groups (BI < 15). Clinical characteristics, CT scan findings, treatment, BI were recorded and statistically analyzed. Clinical characteristics, BI were recorded and statistically analyzed using t-test, exact probability test, multivariable logistic regression analysis with a significant p-value of less than 0.05.
Results
A total of 126 patients, the mean of BI before discharge is 1.45 + 3.30 and BI 6 months is 15.19 + 7.60. There were 72 patients with good functional outcomes and 54 patients with poor functional outcomes. On the basis of multivariate analysis, independent clinical factors associated with good functional outcome were patients with no hospital-acquired pneumonia (Adjusted OR =4.84, 95%CI 1.35-17.35, p-value=0.015), No hydrocephalus finding in brain CT scan (Adjusted OR = 5.11, 95%CI 1.08-24.16, p-value=0.039), Patient can follow command before discharge (Adjusted OR=3.90; 95%CI 1.10-13.82, p-value=0.035).
Conclusions and recommendations
No hospital-acquired pneumonia, no hydrocephalus finding in brain CT scan, patient can follow command before discharge are clinical factors affecting good functional outcome in patients with moderate and severe traumatic brain injury that can be used to plan and select rehabilitation in a community hospital. Prevention of hospital acquired pneumonia is important in patients with traumatic brain injury.
Article Details
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