Incidence and outcomes of pediatric patients with dual diagnosis of traumatic spinal cord injury and brain injury on an inpatient rehabilitation unit.

Abstract

Background: Traumatic brain injury (TBI) and spinal cord injury (SCI) are diagnoses commonly encountered on the pediatric rehabilitation unit. However, there is limited evidence in the literature addressing the incidence of or rehabilitation outcomes in pediatric patients with a dual diagnosis of TBI and SCI.

Objective: To determine incidence and functional outcomes of the dual diagnosis population.

Design: Retrospective cohort study.

Setting: Inpatient rehabilitation unit within an academic pediatric hospital.

Patients: Pediatric patients admitted to a single inpatient rehabilitation unit with a diagnosis of traumatic SCI between 2006 and 2019. Fifty-four patient records were identified and 26 met inclusion criteria.

Interventions: Not applicable.

Main outcome measure: Presence of concomitant TBI in patients with diagnosed SCI.

Results: Seven of 26 patients were given a dual diagnosis of TBI and SCI during their initial rehabilitation hospitalization. After review of charts, authors identified 12 additional patients with suspected dual diagnoses based on injury characteristics and symptoms. There were no significant differences in functional outcomes across diagnosis groups.

Conclusions: Incidence of dual diagnosis among pediatric patients with traumatic SCI was initially found to be 27%; the retrospective review indicated that TBI may be underdiagnosed in this patient population, and the dual diagnosis incidence may be as high as 73%. All patients had improved functional outcomes during their rehabilitation stays regardless of presence or absence of TBI.