Regression-based prediction of long-term outcome following multidisciplinary rehabilitation for traumatic brain injury

Abstract

Studied 100 patients (62 males, 38 females) who had sustained traumatic brain injuries (TBI) in an automobile accident. Patients were a mean age of 27 years (SD = 16.8) and were 6.2 years (SD = 1.7) postinjury. All patients were covered by no-fault automobile insurance in the state of Michigan and had unlimited access to services and treatments as mandated by state law. Patient files were randomly selected from a catastrophic claims office, a reinsuring association established by the Michigan legislature in conjunction with auto no-fault law. Time postinjury was inversely related to virtually all outcome domains assessed. Treatment variables considering both duration and costs, produced little or no significant increase in the prediction of long-term functional outcome, and in the majority of cases were inversely related to outcome. Patients receiving the longest duration of treatment and accumulating the greatest treatment costs displayed the poorest outcome ratings in this sample; some shorter durations of treatment were associated with modest improvements in outcome. The best single predictors of outcome were coma/vegetative state duration and age at accident.