INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Majestic Complex (Posters 61-120) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #82 The Impact of Intoxication at Time of Traumatic Brain Injury on Rehabilitation Responsivity Christopher Waller, University of Nebraska - Lincoln, Lincoln, United States Kathy Chiou, University of Nebraska - Lincoln, Lincoln, United States Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult) Keyword 1: alcohol Keyword 2: brain injury Objective: Identifying predictors of recovery trajectory following moderate to severe traumatic brain injury (msTBI) is prognostically advantageous. Alcohol intoxication at the time of injury (AITI) is a significant risk factor for TBI, and accounts for a large percentage of all cases. However, research on the role of AITI in affecting the survivor’s recovery trajectory has been somewhat inconsistent, with some teams finding neuroprotective effects while others observe negative consequences (e.g., delayed recovery). Indeed, there is evidence suggesting AITI may prolong rehabilitation and worsen neuroinflammation. The present investigation seeks to elucidate differential rehabilitation outcomes in those with and without AITI. It was hypothesized that 1) participants with record of AITI will stay in rehabilitative programming longer and 2) will benefit less from rehabilitation than participants who were not intoxicated at the time of injury (NITI). Participants and Methods: Data were drawn from archival records of a residential rehabilitation facility in the Midwestern United States. Participants (N = 39) were adult survivors of msTBI who were admitted to the facility within 1 year of their injury. Intoxication status was determined by record review and categorized as intoxicated (n = 26) or not (n = 13 ) at the time of their injury. Functional recovery was assessed using the Participation Index of the Mayo Portland Adaptability Inventory (MPAI-P) collected at admission and discharge from the facility. A one-way ANOVA was performed to determine between-group differences in rehabilitative length of stay. Additionally, a mixed-effects ANOVA with length of stay added as a covariate was used to evaluate the degree of functional recovery between groups. Results: The one-way ANOVA showed no significant difference in length of stay at the rehabilitative facility between the AITI and NITI groups (F(3,35) = .410, p > .05). Length of stay was significantly related to change in MPAI-P scores (F(1,36) = 25.02, p < .001, partial η² = .4) indicating that those with a higher amount of impairment across timepoints tended to stay in rehabilitation longer. A large and significant effect of intoxication status at injury remained, even after controlling for length of stay (F(1,36) = 6.31, p = .017, partial η² = .149). Pairwise comparisons indicated survivors in the NITI group (M = 10.08) had significantly lower MPAI-P scores than those in the AITI group (M = 14.42). Conclusions: Contrary to the first hypothesis, no difference was observed in the total length of stay in rehabilitation between those who were and were not intoxicated at time of injury. However, in support of the second hypothesis, those with AITI were noted to receive less benefit from the rehabilitation intervention. These findings suggest that regardless of the amount of rehabilitation services needed, those who were intoxicated at the time of their brain injury tend to display a protracted recovery in societal participation. These results indicate the utility of considering AITI when developing a prognostic profile. Additionally, awareness of these findings may help rehabilitation staff in managing expectations and encourage more individualized treatment planning to increase responsivity to rehabilitative programming in these individuals.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Majestic Complex (Posters 61-120)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #82

The Impact of Intoxication at Time of Traumatic Brain Injury on Rehabilitation Responsivity

Christopher Waller, University of Nebraska - Lincoln, Lincoln, United States
Kathy Chiou, University of Nebraska - Lincoln, Lincoln, United States

Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult)

Keyword 1: alcohol
Keyword 2: brain injury

Objective:

Identifying predictors of recovery trajectory following moderate to severe traumatic brain injury (msTBI) is prognostically advantageous. Alcohol intoxication at the time of injury (AITI) is a significant risk factor for TBI, and accounts for a large percentage of all cases. However, research on the role of AITI in affecting the survivor’s recovery trajectory has been somewhat inconsistent, with some teams finding neuroprotective effects while others observe negative consequences (e.g., delayed recovery). Indeed, there is evidence suggesting AITI may prolong rehabilitation and worsen neuroinflammation. The present investigation seeks to elucidate differential rehabilitation outcomes in those with and without AITI. It was hypothesized that 1) participants with record of AITI will stay in rehabilitative programming longer and 2) will benefit less from rehabilitation than participants who were not intoxicated at the time of injury (NITI).

Participants and Methods:

Data were drawn from archival records of a residential rehabilitation facility in the Midwestern United States. Participants (N = 39) were adult survivors of msTBI who were admitted to the facility within 1 year of their injury. Intoxication status was determined by record review and categorized as intoxicated (n = 26) or not (n = 13 ) at the time of their injury. Functional recovery was assessed using the Participation Index of the Mayo Portland Adaptability Inventory (MPAI-P) collected at admission and discharge from the facility. A one-way ANOVA was performed to determine between-group differences in rehabilitative length of stay. Additionally, a mixed-effects ANOVA with length of stay added as a covariate was used to evaluate the degree of functional recovery between groups.

Results:

The one-way ANOVA showed no significant difference in length of stay at the rehabilitative facility between the AITI and NITI groups (F(3,35) = .410, p > .05). Length of stay was significantly related to change in MPAI-P scores (F(1,36) = 25.02, p < .001, partial η² = .4) indicating that those with a higher amount of impairment across timepoints tended to stay in rehabilitation longer. A large and significant effect of intoxication status at injury remained, even after controlling for length of stay (F(1,36) = 6.31, p = .017, partial η² = .149). Pairwise comparisons indicated survivors in the NITI group (M = 10.08) had significantly lower MPAI-P scores than those in the AITI group (M = 14.42).

Conclusions:

Contrary to the first hypothesis, no difference was observed in the total length of stay in rehabilitation between those who were and were not intoxicated at time of injury. However, in support of the second hypothesis, those with AITI were noted to receive less benefit from the rehabilitation intervention. These findings suggest that regardless of the amount of rehabilitation services needed, those who were intoxicated at the time of their brain injury tend to display a protracted recovery in societal participation. These results indicate the utility of considering AITI when developing a prognostic profile. Additionally, awareness of these findings may help rehabilitation staff in managing expectations and encourage more individualized treatment planning to increase responsivity to rehabilitative programming in these individuals.