Early incorporation of rehabilitation services for severe traumatic brain injury (TBI)
patients is expected to improve outcomes and quality of life. This study aimed to
compare the outcomes regarding the discharge destination and length of hospital stay
of selected TBI patients before and after launching an acute intensive trauma rehabilitation
(AITR) program at King Saud Medical City. It was a retrospective observational before-and-after
study of TBI patients who were selected and received AITR between December 2018 and
December 2019. Participants' demographics, mechanisms of injury, baseline characteristics,
and outcomes were compared with TBI patients who were selected for rehabilitation
care in the pre-AITR period between August 2017 and November 2018. A total of 108
and 111 patients were managed before and after the introduction of the AITR program,
respectively. In the pre-AITR period, 63 (58.3%) patients were discharged home, compared
to 87 (78.4%) patients after AITR (p = 0.001, chi-squared 10.2). The pre-AITR group's
time to discharge from hospital was 52.4 (SD 30.4) days, which improved to 38.7 (SD
23.2) days in the AITR (p < 0.001; 95% CI 6.6-20.9) group. The early integration of
AITR significantly reduced the percentage of patients referred to another rehabilitation
or long-term facility. We also emphasize the importance of physical medicine and rehabilitation
(PM&R) specialists as the coordinators of structured, comprehensive, and holistic
rehabilitation programs delivered by the multi-professional team working in an interdisciplinary
way. The leadership and coordination of the PM&R physicians are likely to be effective,
especially for those with severe disabilities after brain injury.