Resultado después de la lesión traumática de cerebro…(Inglés)

"Resultado después de la lesión traumática de cerebro: Efectos del envejecimiento en la recuperación."

Julie A. Testa PhDa, , , James F. Malec PhDa, Anne M. Moessner MSN, RNb, c and Allen W. Brown MDb

aDepartments of Psychiatry and Psychology, Mayo Clinic, Rochester, MN bPhysical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN cNursing, Mayo Clinic, Rochester, MN

Abstract

Testa JA, Malec JF, Moessner AM, Brown AW. Outcome after traumatic brain injury: effects of aging on recovery.

Objective To identify differences in outcome after traumatic brain injury (TBI) compared with orthopedic injuries as a function of age.

Design Longitudinal data analyses from an inception cohort.

Setting Outpatient rehabilitation program.

Participants Eighty-two orthopedic injury patients and 195 TBI patients.

Interventions Not applicable.

Main Outcome Measures Independent living, employment, and level of functioning 1 to 2 years after injury.

Results Older patients and those with TBI were more likely to have increased dependence postinjury. Older TBI patients were more likely to have changes in employment status compared with orthopedic injury patients younger or TBI. The Mayo-Portland Adaptability Inventory and Disability Rating Scale were moderately predictive of level of functioning, return to employment, and independent living status 1 to 2 years postinjury. Injury severity was only mildly predictive of outcome.

Conclusions The effect of age on outcome affects recovery from neurologic injuries and, to a lesser extent, orthopedic injuries. Outcome after TBI is best predicted by patients’ age and estimates of level of function at discharge. Findings suggest that older patients and those with TBI have a greater likelihood of becoming physically and financially dependent on others. Rehabilitation efforts should focus on maximizing levels of independence to limit financial and emotional costs to patients and their families.

Archives of Physical Medicine and Rehabilitation Volume 86, Issue 9 , September 2005, Pages 1815-1823.