Table 2.
Patient Characteristics by Admission FIM Cognitive Score Subgroup
| Characteristics | Admission FIM Cognitive Score* | ||||||
|---|---|---|---|---|---|---|---|
| Overall (n=2130) | <=6 (n=339) | 7–10 (n=374) | 11–15 (n=495) | 16–20 (n=408) | >=21 (n=504) | P | |
| Demographics | |||||||
| Male (%) | 72.5 | 71.7 | 76.5 | 75.8 | 71.3 | 67.7 | 0.018 † |
| Age at rehabilitation admission (mean, SD) | 44.5 (21.3) | 43.0 (21.9) | 42.3 (20.0) | 43.1 (20.9) | 46.9 (21.6) | 46.8 (21.8) | <.001 ‡ |
| Race/Ethnicity (%) | 0.083 † | ||||||
| Black | 15.1 | 15.3 | 13.9 | 16.8 | 15.4 | 13.9 | |
| White non Hispanic | 74.4 | 77.9 | 73.5 | 73.5 | 74.3 | 73.4 | |
| White Hispanic | 6.2 | 5.0 | 8.0 | 5.7 | 6.6 | 5.8 | |
| Other and unknown§ | 4.4 | 1.8 | 4.5 | 4.0 | 3.7 | 6.9 | |
| Highest education achieved (%) | 0.008 † | ||||||
| Some high school, no diploma | 23.0 | 20.4 | 26.2 | 25.3 | 26.5 | 17.5 | |
| High school diploma | 25.9 | 25.1 | 27.5 | 28.1 | 25.7 | 22.6 | |
| Work towards or completed Associate’s degree | 16.2 | 15.9 | 13.9 | 14.9 | 17.9 | 18.1 | |
| Work towards or completed Bachelor’s degree | 19.7 | 21.2 | 20.3 | 18.8 | 15.9 | 22.0 | |
| Work towards or completed Master’s/Doctoral degree | 9.7 | 11.5 | 8.0 | 8.3 | 8.3 | 12.1 | |
| Unknown | 5.7 | 5.9 | 4.0 | 4.6 | 5.6 | 7.7 | |
| Marital status prior to injury (%) | 0.267 † | ||||||
| Single/never married | 42.6 | 43.7 | 44.9 | 44.8 | 38.2 | 40.9 | |
| Married/common law | 36.5 | 36.3 | 35.6 | 35.8 | 37.0 | 37.9 | |
| Previously married | 17.5 | 16.2 | 15.5 | 16.2 | 22.5 | 17.1 | |
| Other/unknown || | 3.5 | 3.8 | 4.0 | 3.2 | 2.2 | 4.2 | |
| Occupation prior to injury (%) | 0.006 † | ||||||
| Employed and student | 4.0 | 4.1 | 4.0 | 4.4 | 2.9 | 4.4 | |
| Employed only | 47.1 | 45.4 | 48.4 | 47.5 | 43.9 | 49.4 | |
| Unemployed | 13.3 | 13.6 | 15.8 | 13.7 | 14.2 | 10.3 | |
| Retired | 23.1 | 20.9 | 17.9 | 21.0 | 28.4 | 26.4 | |
| Student only | 11.4 | 13.6 | 12.0 | 12.7 | 9.6 | 9.3 | |
| Unknown | 1.1 | 2.4 | 1.9 | 0.6 | 1.0 | 0.2 | |
| Able to drive before injury (%) | 0.128 † | ||||||
| Yes | 73.1 | 70.2 | 75.7 | 75.6 | 69.9 | 73.0 | |
| No | 10.8 | 9.4 | 10.7 | 9.5 | 13.9 | 10.5 | |
| Unknown | 16.1 | 20.4 | 13.6 | 14.9 | 16.2 | 16.5 | |
| Primary payer (%) | <.001 † | ||||||
| Medicare | 19.4 | 18.0 | 15.0 | 18.4 | 23.0 | 22.2 | |
| Medicaid | 15.5 | 20.9 | 18.2 | 16.4 | 17.2 | 7.7 | |
| Private insurance | 24.5 | 26.3 | 24.6 | 30.1 | 24.0 | 17.9 | |
| Centralized (single payer system) | 6.9 | 0.3 | 1.9 | 2.4 | 6.4 | 20.2 | |
| Worker’s compensation | 6.8 | 5.9 | 8.6 | 6.7 | 6.1 | 6.5 | |
| Self pay | 2.2 | 0.9 | 3.5 | 3.4 | 1.5 | 1.4 | |
| MCO/HMO | 14.3 | 13.9 | 18.4 | 14.1 | 13.2 | 12.3 | |
| No-fault auto insurance | 4.5 | 7.1 | 4.0 | 3.2 | 2.9 | 5.8 | |
| None | 2.4 | 3.2 | 2.4 | 2.0 | 2.0 | 2.8 | |
| Other/unknown | 3.4 | 3.5 | 3.5 | 3.2 | 3.7 | 3.0 | |
| Secondary payer (%) | <.001 † | ||||||
| Medicare | 1.8 | 2.1 | 1.3 | 1.6 | 2.7 | 1.4 | |
| Medicaid | 4.2 | 4.4 | 4.5 | 4.8 | 4.2 | 3.2 | |
| Private insurance | 12.7 | 14.5 | 8.8 | 8.5 | 14.2 | 17.3 | |
| Worker’s compensation | 0.3 | 0.0 | 0.0 | 0.2 | 0.2 | 0.8 | |
| Self pay | 3.4 | 1.2 | 4.8 | 4.9 | 2.9 | 2.6 | |
| MCO/HMO | 2.4 | 3.5 | 1.6 | 2.6 | 1.7 | 2.4 | |
| No-fault auto insurance | 6.7 | 8.9 | 5.3 | 6.3 | 6.6 | 6.5 | |
| None | 42.0 | 51.0 | 45.2 | 42.1 | 38.0 | 36.9 | |
| Other/unknown | 26.7 | 14.5 | 28.3 | 29.1 | 29.4 | 29.0 | |
| Admission body mass index (%) | <.001 † | ||||||
| <16 | 1.4 | 2.4 | 2.1 | 1.6 | 1.0 | 0.4 | |
| 16–<=18.5 | 8.5 | 11.8 | 11.0 | 8.1 | 8.1 | 5.2 | |
| >18.5–<=25 | 49.7 | 55.5 | 55.1 | 50.5 | 46.3 | 43.1 | |
| >25–<=30 | 23.6 | 18.0 | 18.7 | 25.1 | 26.5 | 27.6 | |
| >30–<=35 | 7.9 | 6.5 | 7.5 | 7.9 | 8.3 | 9.1 | |
| >35–<=40 | 2.3 | 1.8 | 1.3 | 2.4 | 1.7 | 3.6 | |
| >40 | 1.3 | 0.0 | 1.3 | 1.2 | 1.2 | 2.4 | |
| Unknown | 5.3 | 4.1 | 2.9 | 3.2 | 6.9 | 8.7 | |
| Pre-existing and co-existing conditions | |||||||
| History of alcohol use before injury (%) | 44.6 | 38.3 | 50.0 | 48.1 | 44.6 | 41.1 | 0.005 † |
| Alcohol use at time of injury (%) | 19.1 | 18.6 | 17.4 | 20.2 | 20.1 | 18.5 | 0.816 † |
| History of alcohol abuse before injury (%) | 35.6 | 30.4 | 36.9 | 39.0 | 37.3 | 33.7 | 0.091 † |
| History of drug abuse before injury (%) | 20.5 | 17.7 | 22.5 | 20.8 | 25.0 | 17.1 | 0.024 † |
| Drug abuse at time of injury (%) | 6.4 | 7.7 | 8.0 | 5.9 | 6.9 | 4.6 | 0.217 † |
| ADHD (%) | 7.6 | 6.2 | 7.2 | 7.9 | 8.6 | 7.7 | 0.799 † |
| Anxiety (%) ¶ | 40.9 | 32.5 | 46.5 | 45.3 | 41.4 | 37.5 | <.001 † |
| CAD (%) | 8.9 | 7.1 | 6.4 | 10.3 | 9.8 | 9.9 | 0.166 † |
| CHF (%) | 3.7 | 1.8 | 4.3 | 4.4 | 3.2 | 4.4 | 0.235 † |
| Depression (%) ¶ | 48.9 | 47.5 | 52.9 | 54.1 | 49.8 | 41.1 | <.001 † |
| Diabetes (%) | 16.8 | 21.2 | 15.2 | 21.0 | 14.2 | 12.9 | <.001 † |
| Hypertension (%) | 43.5 | 46.6 | 41.7 | 44.8 | 45.3 | 39.9 | 0.246 † |
| Paralysis (%) | 38.0 | 47.5 | 45.5 | 43.6 | 30.2 | 26.8 | <.001 † |
| Renal failure (%) | 8.4 | 8.6 | 8.6 | 8.1 | 7.8 | 8.7 | 0.989 † |
| Previous brain injury (%) | 8.9 | 5.6 | 7.2 | 9.9 | 12.0 | 8.9 | 0.023 † |
| Number of previous brain injuries (mean, SD) # | 1.3 (0.7) | 1.3 (0.7) | 1.3 (0.6) | 1.3 (0.6) | 1.4 (1.1) | 1.2 (0.5) | 0.649 † |
| Tracheotomy or ventilation on admission (%) | 22.1 | 51.0 | 34.0 | 22.2 | 7.6 | 5.4 | <.001 † |
| Brain injury and severity information | |||||||
| Cause of injury (%) | 0.001 † | ||||||
| Fall | 31.9 | 28.0 | 26.2 | 30.1 | 35.0 | 38.3 | |
| Motor vehicle crash | 55.6 | 63.7 | 57.8 | 57.2 | 52.5 | 49.2 | |
| Sports | 1.8 | 1.2 | 2.4 | 1.0 | 2.2 | 2.4 | |
| Violence | 7.0 | 4.4 | 7.8 | 8.3 | 7.1 | 7.1 | |
| Miscellaneous | 3.6 | 2.7 | 5.9 | 3.4 | 3.2 | 3.0 | |
| GCS score immediately after injury or upon arrival in acute care (%) | <.001 † | ||||||
| Mild (13–15) | 14.7 | 6.8 | 9.1 | 11.1 | 17.9 | 25.6 | |
| Moderate (9–12) | 7.7 | 4.1 | 4.8 | 8.3 | 7.6 | 12.1 | |
| Severe (3–8) | 32.3 | 46.0 | 42.0 | 35.4 | 24.5 | 18.8 | |
| Intubated/sedated | 12.2 | 12.4 | 15.0 | 11.7 | 13.7 | 8.7 | |
| Unknown | 33.0 | 30.7 | 29.1 | 33.5 | 36.3 | 34.7 | |
| Nature of brain injury (%) | 0.045 † | ||||||
| Skull closed, contusion/hemorrhage present | 71.1 | 74.9 | 72.7 | 69.7 | 71.6 | 68.8 | |
| Skull closed, no contusion/hemorrhage | 21.6 | 15.3 | 19.5 | 24.0 | 21.6 | 24.6 | |
| Skull open, contusion/hemorrhage present | 7.3 | 9.7 | 7.8 | 6.3 | 6.9 | 6.5 | |
| Facial fracture (%) | 13.6 | 10.3 | 16.8 | 14.3 | 15.9 | 10.9 | 0.020 † |
| Skull fracture (%) | 26.8 | 25.1 | 32.6 | 28.3 | 25.7 | 23.0 | 0.022 † |
| Brain injury location (%) | 0.034 † | ||||||
| Bilateral brain involvement | 64.2 | 64.9 | 68.7 | 61.8 | 64.7 | 62.3 | |
| Left brain involvement only | 18.4 | 22.4 | 16.3 | 20.0 | 16.4 | 17.3 | |
| Right brain involvement only | 17.5 | 12.7 | 15.0 | 18.2 | 18.9 | 20.4 | |
| Midline shift (%) | <.001 † | ||||||
| No midline shift | 30.5 | 22.4 | 23.8 | 26.5 | 35.8 | 40.9 | |
| >0–<=5 mm of midline shift | 12.4 | 13.6 | 13.6 | 12.5 | 12.5 | 10.9 | |
| >5 mm of midline shift | 12.1 | 13.9 | 17.4 | 11.3 | 11.0 | 8.5 | |
| Midline shift, mm not specified | 11.1 | 15.3 | 9.1 | 10.7 | 9.6 | 11.5 | |
| Unknown | 33.9 | 34.8 | 36.1 | 39.0 | 31.1 | 28.2 | |
| Subdural hematoma (%) | 46.8 | 49.3 | 52.1 | 46.5 | 45.6 | 42.9 | 0.075 † |
| Epidural hematoma (%) | 8.2 | 8.8 | 8.3 | 8.9 | 6.4 | 7.9 | 0.672 † |
| Subarachnoid hemorrhage (%) | 59.2 | 71.1 | 65.0 | 58.2 | 55.1 | 51.0 | <.001 † |
| Intraventricular hemorrhage (%) | 18.6 | 29.2 | 23.8 | 18.0 | 14.2 | 11.7 | <.001 † |
| Brain stem involved at injury (%) | 5.7 | 7.7 | 6.1 | 5.3 | 4.4 | 5.2 | 0.362 † |
| Craniotomy during care episode (%) | 20.3 | 18.6 | 24.1 | 20.6 | 20.6 | 18.5 | 0.289 † |
| Craniectomy during care episode (%) | 7.2 | 12.7 | 9.6 | 6.9 | 2.9 | 5.4 | <.001 † |
| Weight bearing precaution during rehabilitation (%) | 26.0 | 25.1 | 24.3 | 21.8 | 30.4 | 27.8 | 0.038 † |
| Days from injury to rehabilitation admission (mean, SD) | 29.3 (34.3) | 36.5 (38.7) | 34.2 (37.6) | 27.5 (32.3) | 26 (33.5) | 24.9 (30.1) | <.001 ‡ |
| Brain injury component of admission CSI score (mean, SD) | 44.7 (23.7) | 71.4 (19.3) | 62 (17.6) | 47.7 (14.3) | 33.2 (12.6) | 19.7 (10.0) | <.001 ‡ |
| Non-brain injury component of admission CSI score (mean, SD) | 16.9 (15.0) | 19.1 (16.1) | 20.3 (15.2) | 18.1 (14.7) | 16.1 (15.7) | 12.2 (11.9) | <.001 ‡ |
| Moderate to severe dysphagia on admission (%) | 53.4 | 89.1 | 75.4 | 56.4 | 36.0 | 23.4 | <.001 † |
| Moderate to severe aphasia on admission (%) | 46.5 | 74.3 | 68.2 | 50.3 | 37.3 | 15.1 | <.001 † |
| Moderate to severe ataxia on admission (%) | 15.4 | 21.8 | 21.4 | 17.0 | 12.7 | 6.5 | <.001 † |
| Functional indepedence measures | |||||||
| Admission FIM motor score - untransformed (mean, SD) | 34.7 (19.7) | 17.3 (8.8) | 24.0 (13.1) | 33.5 (16.2) | 40.8 (16.4) | 50.8 (20.0) | <.001 ‡ |
| Admission FIM motor score - Rasch transformed (mean, SD) | 33.2 (19.3) | 11.5 (14.5) | 23.2 (16.4) | 34.2 (14.8) | 40.5 (12.5) | 48.3 (15.2) | <.001 ‡ |
| Admission FIM cognitive score - untransformed (mean, SD) | 14.8 (7.2) | 5.3 (0.4) | 8.6 (1.1) | 13.1 (1.4) | 17.9 (1.4) | 24.9 (3.3) | <.001 ‡ |
| Admission FIM cognitive score - Rasch transformed (mean, SD) | 37.2 (19.5) | 2.5 (4.4) | 25.7 (4.8) | 38.4 (3.0) | 47.5 (2.4) | 59.6 (7.7) | <.001 ‡ |
NOTE: Abbreviations: MCO/HMO, Managed care organization/Health maintainance organization; CHF, Congestive heart failure; CAD, Coronary artery disease; ADHD, Attention deficit hyperactivity disorder; GCS, Glasgow Coma Scale; CSI, Comprehensive Severity Index;
*
n=10 patients missing admission FIM cognitive score.
†
Chi-Square analysis.
‡
Analysis of variance test.
§
Miscellaneous includes 69 Asians, 8 Native Americans, 7 Pacific Islanders, and 3 with unknown race.
||
Other/unknown includes 62 Separated status, 2 listed as Significant Other, and 10 with unknown or missing status.
¶
Includes symptoms existing during rehab.
#
Data include only patients who had previous brain injury before the current injury requiring rehabilitation.