Table 2. Association of Patient and Clinical Characteristics With Consciousness Level During Inpatient Rehabilitation.
| Characteristics | Rehabilitation admission | Rehabilitation discharge | ||||||
|---|---|---|---|---|---|---|---|---|
| Consciousness level, No. (%)a | Consciousness level, No. (%)a | |||||||
| With DOC (n = 2058)b | Without DOC (n = 15 412)c | P value | OR (95% CI) | With DOC (n = 414)b,d | Without DOC (n = 16 994)c,e | P value | OR (95% CI) | |
| Patient characteristics | ||||||||
| Age at injury onset, median (IQR), yf | 35 (23-53) | 40 (25-57) | <.001 | NA | 35 (22-58) | 39 (25-56) | .06 | NA |
| Male sex | 1555/2053 (76) | 11 299/15 408 (73) | .02 | 1.136 (1.020-1.264) | 305/414 (74) | 12 501/16 991 (74) | .97 | 1.005 (0.805-1.254) |
| Race/ethnicity | ||||||||
| White | 1393/2057 (68) | 10 172/15 395 (66) | .69 | NA | 266/412 (65) | 11 260/16 978 (66) | .07 | NA |
| Black | 358/2057 (17) | 2850/15 395 (18) | NA | 66/412 (16) | 3127/16 978 (18) | NA | ||
| Asian/Pacific Islander | 51/2057 (2) | 421/15 395 (3) | NA | 20/412 (5) | 452/16 978 (3) | NA | ||
| Native American | 9/2057 (1) | 83/15 395 (1) | NA | 2/412 (1) | 89/16 978 (1) | NA | ||
| Hispanic | 219/2057 (11) | 1684/15 395 (11) | NA | 51/412 (12) | 1846/16 978 (11) | NA | ||
| Otherg | 27/2057 (1) | 185/15 395 (1) | NA | 7/412 (2) | 204/16 978 (1) | NA | ||
| Acute clinical characteristics | ||||||||
| ED GCS motor score, No./total No. (%)h | ||||||||
| 6: Follows commands | 249/1454 (17) | 5506/11 848 (46) | <.001 | NA | 53/311 (17) | 5686/12 946 (44) | <.001 | NA |
| 5: Localizes | 247/1454 (17) | 2159/11 848 (18) | NA | 43/311 (14) | 2354/12 946 (18) | NA | ||
| 4: Withdraws | 240/1454 (17) | 1424/11 848 (12) | NA | 39/311 (12) | 1622/12 946 (13) | NA | ||
| 3: Flexion | 100/1454 (7) | 433/11 848 (4) | NA | 19/311 (6) | 512/12 946 (4) | NA | ||
| 2: Extension | 109/1454 (7) | 284/11 848 (2) | NA | 26/311 (8) | 362/12 946 (3) | NA | ||
| 1: No response | 509/1454 (35) | 2042/11 848 (17) | NA | 131/311 (42) | 2410/12 946 (19) | NA | ||
| Sedated, paralyzed | 530/1984 (27) | 3266/15 114 (22) | NA | 92/403 (23) | 3699/16 645 (22) | NA | ||
| Unknown/missing data | 74/2058 (4) | 298/15 412 (2) | NA | 11/414 (3) | 349/16 994 (2) | NA | ||
| ED GCS motor score <6 | 1205/1454 (83) | 6342/11 848 (54) | <.001 | 4.201 (3.648-4.838) | 258/311 (83) | 7260/12 946 (56) | <.001 | 3.813 (2.831-5.134) |
| TBI cause | ||||||||
| MVC or other high velocity | 1124/2050 (55) | 7527/15 379 (49) | <.001 | 1.266 (1.154-1.389) | 207/413 (50) | 8422/16 961 (50) | .85 | 1.019 (0.838-1.238) |
| Fall or other lower velocity | 487/2052 (24) | 4379/15 404 (28) | <.001 | 0.783 (0.704-0.872) | 102/413 (25) | 4748/16 988 (28) | .15 | 0.845 (0.674-1.060) |
| Acute hospital course characteristics | ||||||||
| Duration of acute care, median (IQR), d | 25 (17-36) | 15 (9-25) | <.001 | NA | 33 (19-47) | 16 (9-26) | <.001 | NA |
| Craniotomy or craniectomy, No./total No. (%) | 559/1577 (35) | 3058/12 299 (25) | <.001 | 1.659 (1.485-1.854) | 132/325 (41) | 3470/13 520 (26) | <.001 | 1.981 (1.582-2.480) |
| Radiologic characteristics, No./total No. (%) | ||||||||
| Intracranial mass effect | ||||||||
| Compression or midline shift | 984/1884 (52) | 5747/14 630 (39) | <.001 | 1.690 (1.535-1.861) | 222/380 (58) | 6488/16 088 (40) | <.001 | 2.079 (1.691-2556) |
| Midline shift >5 mm | 362/1884 (19) | 1922/14 630 (13) | <.001 | 1.572 (1.389-1.781) | 90/380 (24) | 2191/16 088 (14) | <.001 | 1.968 (1.547-2.504) |
| IPH or IVH | ||||||||
| Punctate/petechial hemorrhage | 557/1903 (29) | 3127/14 693 (21) | <.001 | 1.531 (1.376-1.702) | 102/384 (27) | 3565/16 166 (22) | .04 | 1.278 (1.016-1.608) |
| IVH | 770/1903 (40) | 3415 (23) | <.001 | 2.245 (2.033-2.479) | 172 (45) | 4002 (25) | <.001 | 2.467 (2.011-3.026) |
| Extra-axial fluid collection | ||||||||
| SAH or subdural | 1630/1904 (86) | 11 498/14 706 (78) | <.001 | 1.660 (1.452-1.897) | 336/384 (87) | 12 758/16 180 (79) | <.001 | 1.878 (1.384-2.547) |
| Epidural | 220/1900 (12) | 1590/14 701 (11) | .32 | 1.080 (0.930-1.254) | 50/384 (13) | 1757/16 171 (11) | .18 | 1.228 (0.909-1.660) |
| Cortical contusion | 1448/1903 (76) | 9409/14 700 (64) | <.001 | 1.790 (1.602-1.999) | 292/384 (76) | 10 529/16 173 (65) | <.001 | 1.701 (1.343-2.155) |
| Subcortical contusion | 603/1901 (32) | 2662/14 695 (18) | <.001 | 2.100 (1.890-2.333) | 131/384 (34) | 3118/16 166 (19) | <.001 | 2.167 (1.748-2.685) |
Abbreviations: DOC, disorder of consciousness; DRS, Disability Rating Scale; ED, emergency department; GCS, Glasgow Coma Scale; IPH, intraparenchymal hemorrhage; IVH, intraventricular hemorrhage; MVC, motor vehicle collision; NA, not applicable; SAH, subarachnoid hemorrhage; TBI, traumatic brain injury.
a
Total excluded 213 patients with no DRS motor score at rehabilitation admission.
b
With DOC defined as not following commands, or a DRS motor score >0.
c
DRS motor score of 0.
d
Included 51 patients (12%) who did not follow commands at rehabilitation admission.
e
Included 1674 patients (10%) who did not follow commands at rehabilitation admission.
f
Age ≥89 years was set at 89 (n = 157).
g
Other is among the race/ethnicity categories included in the Traumatic Brain Injury Model Systems database.
h
ED GCS scores were available for 13 458 patients (76%).