Effect of Preexisting and Co-Occurring Comorbid Conditions on Recovery in the 5 Years after Rehabilitation for Traumatic Brain Injury

Objective: To determine the relationship between comorbid health conditions and the trajectory of functional recovery 5 years following traumatic brain injury (TBI) rehabilitation. Setting: Two acute rehabilitation facilities. Participants: A total of 407 patients with primary diagnosis of TBI. Design: Prospective, observational. Main Measures: Functional Independence Measure Cognitive and Motor scores. Results: Female gender was negatively associated with the trajectory of motor recovery (P <.001). TBI severity was negatively associated with both motor and cognitive recovery and interacted with time after injury (both Ps <.0001). Hypertension was negatively associated with both motor (P <.0001) and cognitive (P =.0121) recovery, although this relationship diminished over time for motor function (P =.0447). Cardiac conditions were negatively associated with motor recovery (P =.0204), and rate of cognitive recovery was more rapid for patients with cardiac conditions (P =.0088). Depressed patients recovered cognitive function more quickly than those who were not depressed (P =.0196). Diabetes was negatively associated with motor function (P =.0088). Drug/alcohol use was positively associated with motor function (P =.0036). Conclusions: Injury severity remains an important predictor of long-term recovery; however, certain comorbid medical conditions are negatively associated with functional abilities over the first 5 years after injury. Patients being discharged from TBI rehabilitation with comorbid cardiac, hypertensive, diabetic, and/or depressive conditions may benefit from early and ongoing clinical surveillance.