TY - JOUR
T1 - Characteristics and Rehabilitation Outcomes Among Patients With Blast and Other Injuries Sustained During the Global War on Terror
AU - Sayer, Nina A
AU - Chiros, Christine E.
AU - Sigford, Barbara
AU - Scott, Steven
AU - Clothier, Barbara A
AU - Pickett, Treven
AU - Lew, Henry L.
N1 - Funding Information:
Supported by the VA Health Service Research & Development (grant no. RRP 06-150).
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/1
Y1 - 2008/1
N2 - Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, Lew HL. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. Objective: To describe characteristics and rehabilitation outcomes among patients who received inpatient rehabilitation for blast and other injuries sustained in Iraq and Afghanistan during the Global War on Terror. Design: Observational study based on chart review and Department of Veterans Affairs (VA) administrative data. Setting: The 4 VA polytrauma rehabilitation centers (PRCs). Participants: Service members (N=188) admitted to a PRC during the first 4 years of the Global War on Terror for injuries sustained during Operation Iraqi Freedom or Operation Enduring Freedom. Intervention: Multidisciplinary comprehensive rehabilitation program. Main Outcomes Measures: Cognitive and motor FIM instrument gain scores and length of stay (LOS). Results: Most war-injured patients had traumatic brain injury, injuries to several other body systems and organs, and associated pain. Fifty-six percent had blast-related injuries, and the pattern of injuries was unique among those with injuries secondary to blasts. Soft tissue, eye, oral and maxillofacial, otologic, penetrating brain injuries, symptoms of post-traumatic stress disorder, and auditory impairments were more common in blast-injured patients than in those with war injuries of other etiologies. The mechanism of the injury did not predict functional outcomes. LOS was variable, particularly for those with blast injuries. Patients with low levels of independence at admissions made the most progress but remained more dependent at discharge compared with other PRC patients. The rate of gain was slower in this low-functioning group. Conclusions: Blasts produce a unique constellation of injuries but do not make a unique contribution to functional gain scores. Findings underscore the need for assessment and treatment of pain and mental health problems among patients with polytrauma and blast-related injuries. Patients with polytrauma have lifelong needs, and future research should examine needs over time after community re-entry.
AB - Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, Lew HL. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. Objective: To describe characteristics and rehabilitation outcomes among patients who received inpatient rehabilitation for blast and other injuries sustained in Iraq and Afghanistan during the Global War on Terror. Design: Observational study based on chart review and Department of Veterans Affairs (VA) administrative data. Setting: The 4 VA polytrauma rehabilitation centers (PRCs). Participants: Service members (N=188) admitted to a PRC during the first 4 years of the Global War on Terror for injuries sustained during Operation Iraqi Freedom or Operation Enduring Freedom. Intervention: Multidisciplinary comprehensive rehabilitation program. Main Outcomes Measures: Cognitive and motor FIM instrument gain scores and length of stay (LOS). Results: Most war-injured patients had traumatic brain injury, injuries to several other body systems and organs, and associated pain. Fifty-six percent had blast-related injuries, and the pattern of injuries was unique among those with injuries secondary to blasts. Soft tissue, eye, oral and maxillofacial, otologic, penetrating brain injuries, symptoms of post-traumatic stress disorder, and auditory impairments were more common in blast-injured patients than in those with war injuries of other etiologies. The mechanism of the injury did not predict functional outcomes. LOS was variable, particularly for those with blast injuries. Patients with low levels of independence at admissions made the most progress but remained more dependent at discharge compared with other PRC patients. The rate of gain was slower in this low-functioning group. Conclusions: Blasts produce a unique constellation of injuries but do not make a unique contribution to functional gain scores. Findings underscore the need for assessment and treatment of pain and mental health problems among patients with polytrauma and blast-related injuries. Patients with polytrauma have lifelong needs, and future research should examine needs over time after community re-entry.
KW - Brain injuries
KW - Length of stay
KW - Outcome assessment (health care)
KW - Rehabilitation
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U2 - 10.1016/j.apmr.2007.05.025
DO - 10.1016/j.apmr.2007.05.025
M3 - Article
C2 - 18164349
AN - SCOPUS:37349086836
SN - 0003-9993
VL - 89
SP - 163
EP - 170
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 1
ER -
