Rehabilitation outcomes of cardiac and non-cardiac anoxic brain injury: A single institution experience

Objective: To compare the functional outcomes of patients with anoxic brain injury (ABI) due to cardiac and non-cardiac aetiologies. Design: Retrospective chart review over 4 years. Setting: Freestanding rehabilitation hospital. Participants: Thirteen patients with cardiac ABI and 13 patients with non-cardiac ABI. Intervention: Comprehensive, multi-disciplinary inpatient rehabilitation services. Main outcome measures: Rehabilitation hospital length of stay (LOS) and cost; Functional Independence Measure (FIM) scores and its various sub-sets on admission and discharge; FIM efficiency and change; and discharge disposition. Results: Patients with cardiac ABI were similar in gender and ethnicity when compared to patients with non-cardiac ABI but were older (average age 52 vs 42) with a higher percentage of cardiac patients married (77% vs 39%). No statistically significant differences were found between the two groups on all sub-sets of the FIM on admission and discharge as well as the different FIM efficiencies. However, there was a trend for the cardiac ABI patients to have a greater efficiency in improving mobility during rehabilitation when compared to non-cardiac ABI patients. The rehabilitation hospital LOS was ∼28 days less for patients with cardiac ABI (41.49 vs 69.84 days), but this difference was not statistically significant (p = 0.26). The mean rehabilitation cost for patients with cardiac ABI was ∼ $14 000 less than that for those with non-cardiac ABI ($44 181 vs $58 187). This difference was not statistically significant (p = 0.15). Cardiac ABI patients were more likely to be discharged directly to home from rehabilitation when compared to non-cardiac ABI patients (p = 0.06). Conclusion: This pilot study demonstrates some differences in the recovery patterns of patients with ABI who had a cardiac aetiology and those who had non-cardiac aetiologies. While both groups experienced similar progress during rehabilitation, those with cardiac ABI made gains with a shorter LOS and less rehabilitation costs when compared to non-cardiac ABI patients. These data suggest a trend towards greater cost and length of stay for patients with ABI who had non-cardiac aetiologies.