BACKGROUND & AIMS: :OBJECTIVE To study the profile of associated autoimmune diseases in a series of patients with systemic lupus erythematosus (SLE) and see if such associations are linked to IgA deficiency. METHODS Two hundred eighty-one patients with SLE were studied for Ig A levels by nephelometry. Levels equal to or under 0.05g/dL were considered as IgA deficiency. Epidemiological and clinical data, including the presence of associated autoimmune diseases, were extracted from the patient's charts. RESULTS Ig A deficiency was found in 6% of the patients. In 30.2% of SLE patients, there was at least one more autoimmune disease; Hashimoto thyroiditis and Sjögren's syndrome were the most common. No association between the occurrence of associated autoimmune disease with IgA deficiency was found. CONCLUSIONS There is a high prevalence of autoimmune diseases associated with SLE. IgA deficiency does not affect the presence of these associations.

背景与目标： 目的研究一系列系统性红斑狼疮 (SLE) 患者相关自身免疫性疾病的特征，并探讨这种关联是否与IgA缺乏有关。方法采用散射比浊法检测2 81例SLE患者的Ig A水平。等于或低于0.05g/dL的水平被认为是IgA缺乏症。从患者的图表中提取了流行病学和临床数据，包括相关的自身免疫性疾病的存在。结果6% 患者存在Ig A缺陷。在30.2% SLE患者中，至少还有一种自身免疫性疾病; 桥本甲状腺炎和干燥综合征是最常见的。未发现相关自身免疫性疾病与IgA缺乏症之间的关联。结论系统性红斑狼疮相关的自身免疫性疾病患病率较高。IgA缺乏不影响这些关联的存在。

BACKGROUND & AIMS: BACKGROUND:Depression is a well-established comorbidity of heart disease (HD) and is more prevalent in women than in men. Few studies have examined the gender effect on depression in patients with advanced heart disease prior to open heart surgery (OHS), controlling for cardiac indices. Previous studies indicated the health benefit of optimism but often lacked adjustment for medical confounders. This interdisciplinary study investigated gender differences in pre-OHS depression and the role of medical comorbidities and strength factors. METHOD:Two waves of survey data were collected from 481 patients (mean age = 62, female 42%) along with medical indices in the Society of Thoracic Surgeon's (STS) national database used by all US cardiac surgeons. RESULTS:A t test showed significantly higher levels of pre-OHS depressive symptoms in women than in men. In multivariate analyses, the gender effect on depression vanished after entry of other socio-demographics, medical comorbidities, objectively assessed cardiac indices in the STS database, and psychosocial strength factors. Depressive symptoms linked inversely with dispositional optimism and positively with medical comorbidities and religious/spiritual struggle, but not with any cardiac indices. A mediation analysis supported the role of comorbidities in the gender difference. CONCLUSION:Women with heart disease were more depressed, but the gender difference may be partly explained by multiple comorbid conditions that could complicate disease burden. Reinforcing the literature, optimism, but not other strength factors, appeared to counteract depression after adjusting for health and cardiac conditions. The finding suggests that health providers should be more attentive to overall health of women with heart disease and to the positive expectations of OHS patients.

背景与目标：

BACKGROUND & AIMS: :During the last decade, different studies have converged to evidence the high prevalence of comorbidities in subjects with psoriasis. Although a causal relation has not been fully elucidated, genetic relation, inflammatory pathways and/or common environmental factors appear to be underlying the development of psoriasis and the metabolic comorbidities. The concept of psoriasis as a systemic disease directed the attention of the scientific community in order to investigate the extent to which therapeutic interventions influence the onset and evolution of the most prevalent comorbidities in patients with psoriasis. This study presents scientific evidence of the influence of immunobiological treatments for psoriasis available in Brazil (infliximab, adalimumab, etanercept and ustekinumab) on the main comorbidities related to psoriasis. It highlights the importance of the inflammatory burden on the clinical outcome of patients, not only on disease activity, but also on the comorbidities. In this sense, systemic treatments, whether immunobiologicals or classic, can play a critical role to effectively control the inflammatory burden in psoriatic patients.

背景与目标： : 在过去的十年中，不同的研究已经趋同，以证明银屑病患者的合并症患病率很高。尽管因果关系尚未完全阐明，但遗传关系，炎症途径和/或常见的环境因素似乎是牛皮癣和代谢合并症发展的基础。银屑病作为一种全身性疾病的概念引起了科学界的关注，以研究治疗干预对银屑病患者最普遍合并症的发生和演变的影响程度。这项研究提供了巴西可用的银屑病免疫生物学治疗 (英夫利昔单抗，阿达木单抗，依那西普和乌司他单抗) 对与银屑病相关的主要合并症的影响的科学证据。它强调了炎症负担对患者临床结果的重要性，不仅对疾病活动，而且对合并症。从这个意义上讲，无论是免疫生物学还是经典的全身治疗，都可以有效控制银屑病患者的炎症负担。

BACKGROUND & AIMS: :The strongyloidiasis is a parasitic disease that poses as a serious public health problem, mainly in tropical and subtropical countries. Over the years, some conditions, such as advances in corticosteroid treatment and immunosuppressive diseases, have improved not only the increase in cases of strongyloidiasis, but also the emergence of severe forms of the disease and / or deaths. For these reasons, the objective of this study is to make a critical analysis of the occurrence of strongyloidiasis in patients with comorbidities, describing clinical and epidemiological characteristics associated with these diseases that can highlight the importance of monitoring this parasitosis in most susceptible groups.

背景与目标： : 圆线虫病是一种寄生虫病，主要在热带和亚热带国家引起严重的公共卫生问题。多年来，一些条件，如皮质类固醇治疗和免疫抑制疾病的进展，不仅改善了圆线虫病病例的增加，而且改善了严重形式的疾病和/或死亡。由于这些原因，本研究的目的是对合并症患者的圆线虫病的发生进行批判性分析，描述与这些疾病相关的临床和流行病学特征，这些特征可以突出在大多数易感人群中监测这种寄生虫病的重要性。

BACKGROUND & AIMS: BACKGROUND:Hospitalized COVID-19 patients tend to be older and frequently have hypertension, diabetes, or coronary heart disease, but whether these comorbidities are true risk factors (ie, more common than in the general older population) is unclear. We estimated associations between preexisting diagnoses and hospitalized COVID-19 alone or with mortality, in a large community cohort. METHODS:UK Biobank (England) participants with baseline assessment 2006-2010, followed in hospital discharge records to 2017 and death records to 2020. Demographic and preexisting common diagnoses association tested with hospitalized laboratory-confirmed COVID-19 (March 16 to April 26, 2020), alone or with mortality, in logistic models. RESULTS:Of 269 070 participants aged older than 65, 507 (0.2%) became COVID-19 hospital inpatients, of which 141 (27.8%) died. Common comorbidities in hospitalized inpatients were hypertension (59.6%), history of fall or fragility fractures (29.4%), coronary heart disease (21.5%), type 2 diabetes (type 2, 19. 9%), and asthma (17.6%). However, in models adjusted for comorbidities, age group, sex, ethnicity, and education, preexisting diagnoses of dementia, type 2 diabetes, chronic obstructive pulmonary disease, pneumonia, depression, atrial fibrillation, and hypertension emerged as independent risk factors for COVID-19 hospitalization, the first 5 remaining statistically significant for related mortality. Chronic kidney disease and asthma were risk factors for COVID-19 hospitalization in women but not men. CONCLUSIONS:There are specific high-risk preexisting comorbidities for COVID-19 hospitalization and related deaths in community-based older men and women. These results do not support simple age-based targeting of the older population to prevent severe COVID-19 infections.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Conventionally, little attention has been given to the association of risk factors and medical comorbidities with male sexual dysfunctions. Although that association has been recently shown in many studies, it is not yet well investigated in the Saudi community. AIM:To investigate the association of risk factors and medical comorbidities with male sexual dysfunctions in the Saudi community. METHODS:A total of 1,464 male patients with a clinical diagnosis of sexual dysfunctions were enrolled in this study. All patients were assessed for sexual functions using different domains of the International Index for Erectile Function. Patients were also interviewed for sociodemographic data, medical history, and risk factors for erectile dysfunction (ED). Routine laboratory investigations, plus total testosterone and prolactin assessments, were offered to all patients. Assessments of penile vasculature using Doppler ultrasonography and rigidometer were performed. RESULTS:A total of 92.6% of the patients had ED, 50.8% had premature ejaculation (PE), and 7.6% had low sexual desire. There was a significant association between increased age and increased severity of ED. In total, 20% had psychogenic cause, whereas 80% had organic cause of ED. Of the patients, 10.2% had mild, 41% had moderate, and 48.8% had severe ED. There were significant associations between endocrinopathy and both low sexual desire and PE (P < 0.05). There were significant associations between increased severity of ED and presence of diabetes, hypertension, dyslipidemia, ischemic heart disease, myocardial infarction, and psychological disorders. There were significant associations between increased severity of ED and increased values of end diastolic velocity, decreased values of peak systolic velocity, resistive index, rigidometer, and decreased response to intracavernosal injection (P < 0.001). CONCLUSION:This study provides an assessment of the association of risk factors and medical comorbidities with male sexual dysfunctions in ambulatory service in this community.

背景与目标：

BACKGROUND & AIMS: :Identification of individuals at risk of developing disease comorbidities represents an important task in tackling the growing personal and societal burdens associated with chronic diseases. We employed machine learning techniques to investigate to what extent data from longitudinal, nationwide Danish health registers can be used to predict individuals at high risk of developing type 2 diabetes (T2D) comorbidities. Leveraging logistic regression-, random forest- and gradient boosting models and register data spanning hospitalizations, drug prescriptions and contacts with primary care contractors from >200,000 individuals newly diagnosed with T2D, we predicted five-year risk of heart failure (HF), myocardial infarction (MI), stroke (ST), cardiovascular disease (CVD) and chronic kidney disease (CKD). For HF, MI, CVD, and CKD, register-based models outperformed a reference model leveraging canonical individual characteristics by achieving area under the receiver operating characteristic curve improvements of 0.06, 0.03, 0.04, and 0.07, respectively. The top 1,000 patients predicted to be at highest risk exhibited observed incidence ratios exceeding 4.99, 3.52, 1.97 and 4.71 respectively. In summary, prediction of T2D comorbidities utilizing Danish registers led to consistent albeit modest performance improvements over reference models, suggesting that register data could be leveraged to systematically identify individuals at risk of developing disease comorbidities.

背景与目标： : 识别有患疾病合并症风险的个体是应对与慢性疾病相关的日益增长的个人和社会负担的一项重要任务。我们采用机器学习技术来调查来自丹麦全国范围内的纵向健康登记册的数据在多大程度上可以用于预测罹患2型糖尿病 (T2D) 合并症的高风险个体。利用逻辑回归、随机森林和梯度提升模型，并登记来自> 200,000名新诊断为T2D的个体的住院、药物处方和初级保健承包商接触的数据，我们预测了心力衰竭 (HF) 、心肌梗死 (MI) 、中风 (ST) 的五年风险，心血管疾病 (CVD) 和慢性肾脏疾病 (CKD)。对于HF、MI、CVD和CKD，基于寄存器的模型通过分别实现0.06、0.03、0.04和0.07的接收器工作特性曲线下的面积改进而优于利用规范个体特性的参考模型。预计风险最高的前1,000名患者的发生率分别超过4.99、3.52、1.97和4.71。总之，利用丹麦寄存器对T2D合并症的预测导致了与参考模型相比持续的尽管适度的性能改善，这表明可以利用寄存器数据来系统地识别有发生疾病合并症风险的个体。

BACKGROUND & AIMS: :Although somatic complains are the predominant reasons for seeking general medical care, there has been limited research on the clinical presentation of somatic symptoms in primary care settings in developing countries. The frequency of somatic symptoms in primary care in Qatar and its relationship to comorbidities of mental disorders is presented here. A total of 2,320 Arab patients were approached, of whom 76% agreed to participate for the survey conducted among primary healthcare (PHC) centre patients. The study was conducted with the help of general practitioners (GPs), using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ)-8 for depression, the Generalized Anxiety Disorder Scale (GAD)-7 for anxiety, PHQ-15 for somatic symptoms and the Psychological Stress Measure (PSM)-9 for stress. Of the subjects with somatic symptoms (229 cases), most were Qataris (57.2%). Poor hearing (52.1%), palpitation (47.1%) and stomach pain (43.8%) were the most common in men, whereas constipation (54.6%), feeling depressed (50.9%), and poor hearing (50.6%) were the most common in women; 48.5% had more than four somatic symptoms. Somatic symptoms were severe in 31.9%. Somatic symptoms were associated with depression (15.3%), anxiety (8.7%) and stress disorders (19.2%). The study findings revealed that somatic symptoms were significantly associated with socio-economic status. Somatic symptoms were significantly associated with depression, anxiety and stress disorders.

背景与目标： : 尽管躯体疾病是寻求一般医疗保健的主要原因，但在发展中国家的初级保健机构中，关于躯体症状的临床表现的研究有限。本文介绍了卡塔尔初级保健中躯体症状的发生频率及其与精神障碍合并症的关系。共接触了2,320名阿拉伯患者，其中76% 名同意参加在初级保健 (PHC) 中心患者中进行的调查。该研究是在全科医生 (GPs) 的帮助下进行的，使用一般健康问卷 (GHQ-12)，患者健康问卷 (PHQ)-8用于抑郁症，广泛焦虑症量表 (GAD)-7用于焦虑，躯体症状的PHQ-15和压力的心理压力测量 (PSM)-9。在具有躯体症状的受试者中 (229例)，大多数是卡塔尔人 (57.2% 例)。男性最常见的是听力差 (52.1%)，心悸 (47.1%) 和胃痛 (43.8%)，而女性最常见的是便秘 (54.6%)，情绪低落 (50.9%) 和听力差 (50.6%); 48.5% 有四种以上的躯体症状。31.9% 的躯体症状严重。躯体症状与抑郁 (15.3%) 、焦虑 (8.7%) 和应激障碍 (19.2%) 相关。研究结果表明，躯体症状与社会经济地位显着相关。躯体症状与抑郁，焦虑和压力障碍显着相关。

BACKGROUND & AIMS: :HIV infection and antiretroviral therapies have detrimental effects on bone metabolism, but data on their impact on fracture risk are controversial. We conducted a population-based cohort study to explore the association between clinical diagnosis of HIV infection and hip and major osteoporotic fracture risk. Data were obtained from the SIDIAP(Q) database, which contains clinical information for >2 million patients in Catalonia, Spain (30% of the population). We screened the database to identify participants with a clinical diagnosis of HIV infection, and ascertained incident hip and osteoporotic major fractures in the population aged 40 years or older in 2007 to 2009. In addition, data on incident fractures involving hospital admission were obtained from the Hospital Admissions database. Cox regression models were used to estimate hazard ratios (HRs) for the HIV-infected versus uninfected participants. Models were adjusted for age, sex, body mass index, smoking status, alcohol drinking, oral glucocorticoid use, and comorbid conditions (Charlson index). Among 1,118,156 eligible participants, we identified 2489 (0.22%) subjects with a diagnosis of HIV/AIDS. Age- and sex-adjusted HR for HIV/AIDS were 6.2 (95% confidence interval [CI] 3.5-10.9; p < 0.001) and 2.7 (2.01-3.5; p < 0.001) for hip and major fractures, respectively; this remained significant after adjustment for all mentioned potential confounders: HR 4.7 (2.4-9.5; p < 0.001) and 1.8 (1.2-2.5; p = 0.002). After stratifying by age, the association between HIV infection and major fractures was attenuated for those aged <59 years (adjusted HR 1.35 [0.88-2.07], p = 0.17) but appeared stronger in older patients (adjusted HR 2.11 [1.05-4.22], p = 0.035). We report a strong association between HIV infection and hip fracture incidence, with an almost fivefold increased risk in the HIV infected, independent of sex, age, smoking, alcohol drinking, and comorbidities. Similarly, we demonstrate a 75% higher risk of all clinical fractures and a 60% increase in risk of non-hip clinical fractures among patients with a diagnosis of HIV infection.

背景与目标： : HIV感染和抗逆转录病毒疗法对骨代谢有不利影响，但有关其对骨折风险影响的数据仍存在争议。我们进行了一项基于人群的队列研究，以探讨HIV感染的临床诊断与髋部和主要骨质疏松性骨折风险之间的关系。数据是从SIDIAP(Q) 数据库获得的，该数据库包含西班牙加泰罗尼亚> 200万名患者的临床信息 (占人口的30%)。我们对数据库进行了筛选，以识别临床诊断为HIV感染的参与者，并确定了40岁以上人群中发生的髋关节和骨质疏松性主要骨折2007年2009年。此外，从医院入院数据库中获得了涉及入院的突发骨折的数据。Cox回归模型用于估计HIV感染与未感染参与者的风险比 (HRs)。对模型进行了年龄，性别，体重指数，吸烟状况，饮酒，口服糖皮质激素使用和合并症的校正 (Charlson指数)。在1,118,156名符合条件的参与者中，我们确定了2489 (0.22%) 诊断为HIV/AIDS的受试者。对于髋部和主要骨折，年龄和性别校正的HR分别6.2 (95% 置信区间 [CI] 3.5-10.9; P  <  0.001) 和2.7 (2.01-3.5; P  <  0.001); 在对所有提到的潜在混杂因素进行校正后，这仍然很重要: HR 4.7 (2.4-9.5; P  <  0.001) 和1.8 (1.2-2.5; P   =   0.002)。按年龄分层后，年龄 <59岁 (调整后的HR 1.35 [0.88-2.07]，p   =   0.17) 的患者HIV感染与主要骨折之间的关联减弱，但在老年患者中表现更强 (调整后的HR 2.11 [1.05-4.22]，p   =   0.035)。我们报告了HIV感染与髋部骨折发生率之间的密切关联，HIV感染的风险几乎增加了五倍，而与性别，年龄，吸烟，饮酒和合并症无关。同样，我们证明在诊断为HIV感染的患者中，所有临床骨折的风险75% 高，非髋部临床骨折的风险60% 增加。

BACKGROUND & AIMS: OBJECTIVE:Investigate the prevalence, comorbidities, and correlates of challenging behaviors among clients of the New South Wales Brain Injury Rehabilitation Program. SETTING:All community-based rehabilitation services of the statewide program. PARTICIPANTS:Five hundred seven active clients with severe traumatic brain injury. DESIGN:Prospective multicenter study. MAIN MEASURES:Eighty-eight clinicians from the 11 services rated clients on the Overt Behaviour Scale, Disability Rating Scale, Sydney Psychosocial Reintegration Scale-2, Care and Needs Scale, and Health of the Nation Outcome Scale-Acquired Brain Injury. RESULTS:Overall prevalence rate of challenging behaviors was 54%. Inappropriate social behavior (33.3%), aggression (31.9%), and adynamia (23.1%) were the 3 most common individual behaviors, with 35.5% of the sample displaying more than 1 challenging behavior. Significant associations were found between increasing levels of challenging behavior and longer duration of posttraumatic amnesia, increasing functional disability, greater restrictions in participation, increased support needs, and greater degrees of psychiatric disturbance, respectively (P < 0.004). Multivariate binomial logistic regression found that premorbid alcohol abuse, postinjury restrictions in participation, and higher levels of postinjury psychiatric disturbance were independent predictors of challenging behavior. CONCLUSIONS:Challenging behaviors are widespread among community-dwelling adults with severe traumatic brain injury. Services need to deliver integrated anger management, social skills, and motivational treatments.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Major increases in the survival of people with Down syndrome during the last two generations have resulted in extended periods of adulthood requiring specialist care, which in turn necessitates greater understanding of the nature, timing and impact of comorbidities associated with the disorder. METHOD:The prevalence of five comorbidities reported as common in adults with Down syndrome, visual impairment, hearing impairment, epilepsy, thyroid disorders and dementia was assessed by decade of life. RESULTS:From early adulthood, people with Down syndrome are at enhanced risk of developing new comorbidities and they may present with multiple conditions. Three specific challenges are identified and discussed: are comorbidities detected in a timely manner, is the clinical progress of the disorder adequately understood, and who is responsible for the provision of care? CONCLUSIONS:Further detailed investigations into the development and treatment of comorbidities across the lifespan are needed for a successful longitudinal approach to healthcare in people with Down syndrome. Implementation of this approach will better inform healthcare providers to ensure continuity of care with advancing age.

背景与目标：

BACKGROUND & AIMS: :There is an unmet need to improve therapy for neuropsychiatric comorbidities that are highly prevalent in persons with epilepsy (PWE). However, diagnosing and monitoring the neurobehavioral symptoms is challenging as their presentation can overlap with seizures. In this retrospective study, we report the advantage of chronic ambulatory electrocorticography (ECoG) from implanted Responsive Neurostimulator System (RNS®) in characterizing these psychosomatic paroxysms as a possible ictal, postictal, or interictal phenomenon and how the diagnosis guided the therapy choices. Five out of 21 patients with RNS had neuropsychiatric symptoms (panic attack, psychosis, conversion, and somatization disorders) that overlapped with their seizure semiology and were found to benefit from the use of RNS ECoG data by timely diagnosing and titrating targeted therapies. The cases illustrate the use of RNS ECoG data in diagnosing and improving the management of comorbidities in PWE. The ability to access RNS ECoG data and correlate it with patient symptoms is unique among available therapeutic options for PWE.

背景与目标： : 对于癫痫患者 (pwwe) 中非常普遍的神经精神合并症，改善治疗的需求尚未得到满足。然而，诊断和监测神经行为症状具有挑战性，因为它们的表现可能与癫痫发作重叠。在这项回顾性研究中，我们报告了植入的反应性神经刺激器系统 (RNS) 的慢性动态皮层脑电图 (ECoG) 的优势®) 将这些心身发作表征为可能的发作期，发作期或发作期现象，以及诊断如何指导治疗选择。在21例RNS患者中，有5例具有与癫痫发作符号学重叠的神经精神症状 (惊恐发作，精神病，转换和躯体化障碍)，并通过及时诊断和滴定靶向治疗而受益于RNS ECoG数据的使用。这些案例说明了RNS ECoG数据在诊断和改善pw我们合并症中的管理中的应用。访问RNS ECoG数据并将其与患者症状相关联的能力在pwwe的可用治疗选择中是独一无二的。

BACKGROUND & AIMS: :Evidence continues to accumulate on the rising burden of diabetes mellitus at a higher pace in Africa. In a series of two papers, we sought to summarise recent evidence on diabetes and obesity in Africa based on a systematic review of studies published between January 2002 and October 2012. This first paper on the prevalence, pathogenesis and comorbidities shows that the increase in diabetes prevalence has paralleled that of obesity in Africa. Recent surveys on diabetes and obesity have been largely suboptimal. Hence, the need for more representative and robust continent-wide prevalence figures, which may be somehow achieved through pooling of existing data. Prospective studies linking environmental risk factors to disease occurrence and outcomes remain scarce, and genetic factors for diabetes or obesity have not been extensively assessed. The health consequences of diabetes are manifold, and include a complex interaction with other conditions like HIV infection and sickle cell disease/trait.

背景与目标： : 非洲糖尿病负担日益增加的证据继续积累。在两篇论文中，我们试图根据对2002年1月和2012年10月之间发表的研究的系统回顾，总结非洲糖尿病和肥胖的最新证据。关于患病率，发病机制和合并症的第一篇论文表明，糖尿病患病率的增加与非洲肥胖的增加平行。最近关于糖尿病和肥胖的调查基本上是次优的。因此，需要更具代表性和强大的全大陆流行率数字，这可以通过汇集现有数据以某种方式实现。将环境危险因素与疾病发生和结局联系起来的前瞻性研究仍然很少，并且尚未广泛评估糖尿病或肥胖的遗传因素。糖尿病对健康的影响是多方面的，包括与其他疾病 (如HIV感染和镰状细胞疾病/特征) 的复杂相互作用。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: OBJECTIVE:To identify, for patients in states of seriously impaired consciousness, comorbid conditions present during inpatient rehabilitation and their association with function at 1 year. DESIGN:Abstracted data from a prospective cross-sectional observational study with data collection occurring January 1996 through December 2007. SETTING:Four inpatient rehabilitation facilities in metropolitan areas. PARTICIPANTS:The study sample of 68 participants is abstracted from a database of 157 patients remaining in states of seriously impaired consciousness for at least 28 days. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURE:One-year cognitive, motor, and total FIM score. RESULTS:The most common medical complications during inpatient rehabilitation for the study sample are active seizures (46%), spasticity (57%), urinary tract infections (47%), and hydrocephalus with and without shunt (38%). Presence of ≥3 medical complications during inpatient rehabilitation, controlling for injury severity, is significantly (P<.05) associated with poorer total FIM and FIM motor scores 1 year after injury. The presence of hydrocephalus with and without shunt (r=-.20, -.21, -.18; P ≤.15), active seizures (r=-.31, -.22, -.42), spasticity (r=-.38, -.28, -.40), and urinary tract infections (r=-.25, -.24, -.26) were significantly (P<.10) associated with total FIM, FIM cognitive, and FIM motor scores, respectively. CONCLUSIONS:Reported findings indicate that persons in states of seriously impaired consciousness with higher numbers of medical complications during inpatient rehabilitation are more likely to have lower functional levels 1-year postinjury. The findings indicate that persons with ≥3 medical complications during inpatient rehabilitation are at a higher risk for poorer functional outcomes at 1 year. It is, therefore, prudent to evaluate these patients for indications of these complications during inpatient rehabilitation.

背景与目标：