Functional recovery following traumatic vs non-traumatic brain injury: A case-controlled study

PRIMARY OBJECTIVE: To explore differences in rate of recovery and functional outcome in case-matched patients with traumatic (TBI) vs non-traumatic brain injury (non-TBI) during inpatient rehabilitation and 1 year post-insult. RESEARCH DESIGN: Retrospective comparison study and case-controlled design. METHODS AND PROCEDURES: Demographic data, severity of injury, functional outcome measures and outcomes at 1 year follow-up were collected on 573 patients (404 TBI; 169 non-TBI) admitted to a multidisciplinary neurorehabilitation programme. After general cohort comparisons, 86 TBI and 86 non-TBI patients were matched on age, severity of injury and functional outcome scores. MAIN OUTCOMES AND RESULTS: In the general cohort analyses, TBI patients demonstrated better outcomes at discharge as indicated by lower Disability Rating Scale (DRS) scores and higher gain and efficiency scores on both motor and cognitive sub-scales of the Functional Independence Measure (FIM). After matching patients, TBI patients showed greater functional improvement throughout their rehabilitation stay. Outcomes at 1 year follow-up were mixed; TBI patients showed better outcomes compared to non-TBI patients on DRS scores; however, FIM scores were not significantly different. CONCLUSIONS: Results from the present study support the hypothesis that TBI patients achieve greater functional improvements compared to non-TBI patients when matched according to injury and demographic characteristics.