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discharge. Among those with a reported psychosocial health related
quality of life score, 135 had a score at baseline, 130 at admission, and
64 reported post-discharge. The cohort was between ages 4-21, pri-
marily Caucasian, male, and English speaking. Patient and family-
reported physical HRQOL improved significantly from the time of
rehabilitation admission to outpatient follow-up (mean score 20.2 to
59.7, P
<
.001). Psychosocial HRQOL improved, though to a lesser
extent (mean score 55.8 to 71.2, P
<
.001).
Conclusions:
Patient and family-reported physical and psychosocial
HRQOL, which are impacted significantly by new functional impair-
ment, are seen to improve significantly through a course of inpatient
rehabilitation. Despite significant loss to follow-up, we were able to
determine the magnitude of change was greater than the 10-point
decrement previously clinically correlated with an increase in 30-day
readmissions and emergency department return visits. Inpatient
rehabilitation is associated with important benefits for perceived
HRQOL.
Level of Evidence:
Level III
CATEGORY: NEUROLOGICAL REHABILITATION
Poster 481:
Alcohol Withdrawal and Early Outcomes Following Inpatient
Rehabilitation for Traumatic Brain Injury
Russell Lacey, MD (Virginia Commonwealth Univ Hlth Sys, Richmond,
VA, United States)
Disclosures:
Russell Lacey: I Have No Relevant Financial Relationships
To Disclose
Objective:
To compare inpatient rehabilitation outcomes for in-
dividuals with traumatic brain injury (TBI) based on whether they were
also managed for symptoms of alcohol withdrawal during acute care.
Design:
Observational research, retrospective chart review.
Setting:
Level I trauma center, acute care and inpatient rehabilitation.
Participants:
Patients who completed inpatient rehabilitation for
moderate-to-severe TBI and who were enrolled in the TBI model sys-
tems at the study site (n
¼
234). A retrospective chart review deter-
mined which patients were managed for alcohol withdrawal using the
Clinical Institute Withdrawal Assessment (CIWA) protocol. Patients
were divided into two groups: TBI-only (n
¼
167) and TBI+CIWA (n
¼
67).
Interventions:
Not applicable.
Main Outcome Measures:
Disability Rating Scale (DRS).
Results:
The two groups were comparable with no significant differ-
ences related to initial injury severity, length of posttraumatic
amnesia (PTA), gender, years of education, acute care length of stay
(LOS), rehabilitation LOS, and DRS scores at admission to rehabilita-
tion. However, subjects in the TBI+CIWA group were significantly
(P
¼
.050) older (M
¼
45.9, SD
¼
12.3) than those in the TBI-only group
(M
¼
40.9, SD
¼
19.2). There was a significant difference between groups
for DRS scores at discharge (F(1,227)
¼
4.050, P
¼
.045), with the TBI+-
CIWA group having lower scores (M
¼
6.4, SD
¼
1.9) compared to the TBI-
only group (M
¼
7.0, SD
¼
2.2).
Conclusions:
Despite being similar on measures of initial injury
severity and functional status at admission to inpatient rehabilitation,
the TBI+CIWA group had significantly lower DRS scores (i.e., less
overall disability) at discharge compared to the TBI-only group. These
findings suggest that individuals recovering from TBI who were also
managed for alcohol withdrawal may have a more favorable initial
recovery trajectory than those with TBI-only. It is also possible that
initial injury severity indicators (e.g., PTA) may be confounded with
symptoms of alcohol withdrawal or withdrawal management resulting
in overestimation of injury severity.
Level of Evidence:
Level II
CATEGORY: QUALITY IMPROVEMENT
Poster 482:
Feasibility of an Audit System for Canadian Sonographers in
Generalist Ultrasound
Robert Dima, none (McMaster University, Grimsby, ON, Canada),
Calin Vasile, BSc Medical Science, RDMS, RVT, CRGS, CRCS, CRVS,
Vinicius Tieppo Francio, MD/PhD(c)
Disclosures:
Robert Dima: I Have No Relevant Financial Relationships
To Disclose
Objective:
To develop and assess the feasibility of a working audit
model for generalist medical sonographers in Canada. The rapid
growth and development of the dynamic field of sonography highlights
the importance to produce quantitative evidence for Canadian
sonographer’s ability in the current healthcare environment. The audit
method was employed to measure performance and identify targets of
change, setting a template for further large scale investigations which
may, in the future, influence and inform considerations involving role
expansion of sonographers in Canada.
Design:
Quantitative literature review.
Setting:
Radiological Sciences Department of a Canadian Health Care
Institution.
Participants:
429 subjects.
Interventions:
An audit method of 433 generalist ultrasound exams
was performed in the Radiological Sciences Department of a Canadian
healthcare institution. Technologist reports were contrasted with
radiologist final reports and a degree of agreement (DoA) was assigned
for each exam package by content analysis.
Main Outcome Measures:
N/A.
Results:
75% (322/429) exam packages were ranked as DoA 1 (greatest
agreement between sonographer and radiologist), 20% (86/429) were
ranked as DoA 2, 4% (16/429) were ranked as DoA 3 and 1% (5/429) were
ranked as DoA 4 (significant discrepancy between sonographer and
radiologist). No definite trends in agreement between sonographer and
radiologist based on the type of exam being performed were evident.
Conclusions:
The findings reveal good (75%) agreement between so-
nographer and radiologist on imaging findings as they are recorded in
the technical impression sheets and radiologist reports. When dis-
crepancies arise, they are usually minor and involve the omission of
incidental/additional findings by the radiologist. The methods
employed in this study may be suitable for large-scale audits of so-
nographer performance and reporting practices, as individual review
of images may present significant logistical challenges.
Level of Evidence:
Level IV
CATEGORY: PAIN & SPINE MEDICINE
Poster 483:
Immediate vs. Prolonged Pain Relief After Sacroiliac
Joint Injection with Anesthetic and Corticosteroid:
A Prospective Study
David J. Kennedy, MD (Stanford University, Redwood City, CA, United
States), Charles A. Odonkor, MD, MA, Patricia Z. Zheng, MD,
Byron J. Schneider, MD, Lisa Huynh, MD, Joshua Levin, MD,
Ramin Kordi, MD PhD
Disclosures:
David Kennedy: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To determine the relationship of immediate and short
term responses to an injection into the sacroiliac joint (SIJ) at pre-
dicting pain at 6 months.
S286
Abstracts / PM R 9 (2017) S131-S290