Patient Prognostication in Traumatic Spinal Cord Injury and Brain Injury

The role of the physical medicine and rehabilitation consultant in evaluating patients following severe neurologic injury is a valuable but difficult proposition. Appropriate distribution of acute treatment and rehabilitation resources is of the utmost importance. For prognostication to be clinically useful, physiatrists must provide a reasonable impression of what life will be like for the patient in the longer term, which is often difficult during the acute period following acquired brain injury and spinal cord injury. Outcome prediction involves making probability statements that depend on a rational relationship between outcome and parameters derived from early data. This chapter will review prognostication principles for acquired brain and spinal cord injuries. This information is vital for families, caregivers, and acute care treatment teams to better understand prognosis and outcomes to guide clinical care and resource allocation.