Cognitive correlates with functional outcomes after anoxic brain injury: A case-controlled comparison with traumatic brain injury

OBJECTIVES: To assess the effectiveness of inpatient rehabilitation in adults who have sustained an anoxic brain injury (AnBI). Secondly, to identify areas of cognition that predict functional outcomes at discharge. DESIGN: Retrospective, matched case-controlled study. METHODS: Ten patients with moderate-to-severe AnBI and 10 patients with traumatic brain injury (TBI), treated in an inpatient neurorehabilitation programme, were matched on age, acute care length of stay and admission Functional Independence Measure (FIM). Functional outcome was assessed using the FIM and Disability Rating Scale (DRS). RESULTS: Patients with AnBI performed worse on all measures of functional outcome relative to patients with TBI. Patients with AnBI achieved significantly lower FIM motor and cognitive gain compared with patients with TBI (11.5, SD 13.6 vs. 31.0, SD 19.7 and 2.4, SD 3.9 vs. 7.5, SD 4.2, respectively (p < 0.02)). DRS data showed similar trends of functional improvement between the groups. Several neuropsychometric tests correlated with functional outcome (p < 0.01). CONCLUSIONS: Patients with AnBI had worse functional outcomes following rehabilitation than patients with TBI, confirming the results of previous reports. Poor cognitive function predicted poor functional outcomes on the FIM and somewhat on the DRS. Research is needed to assess why these differences occur and to improve or develop new effective rehabilitation treatments for AnBI.