Personalizing Inpatient Rehabilitation for Acutely Injured Trauma Patients Through Innovative Morphomics

Inpatient rehabilitation programs are important for acutely injured patients who have suffered severe physical trauma from burn, falls, major car accidents, and industrial incidents. Among this very heterogeneous patient population, identifying those who would benefit greatly and quickly from rehabilitation program, those who would benefit less, and those who are not
ready to start rehabilitation is a very important clinical problem in order to optimize when and who should enter such programs.

Aim 1: To develop a prediction model based on morphological features and other factors to predict the probability of successful completion of rehabilitation.

Aim 2: To evaluate the association between morphological features and rates of functional gains.

In this project, we are using a radiologic phantom and high-throughput image analysis on quantitative CT (qCT) to reconstruct the individual 3-D anatomy and to quantify morphomic measurements, such as fat distribution, vascular calcification, bone mineral density, muscle density and size, and solid organ imaging characteristics. We developed statistical methods to evaluate the prognostic effect of these quantitative morphological effects on the outcomes from rehabilitation, which will be obtained through eRehabData, an inpatient rehabilitation outcomes system offered by the American Medical Rehabilitation Providers Association. The prediction model that we developed is based on morphological features and other factors to predict the discharge living setting. Through the novel statistical models, we found a strong association between morphological features and functional gains over time. Specifically, our study leverages novel technologies and available data to communicate rehabilitation efficacy and the associated cost. We extracted a large body of clinical registry data from eRehabData and data from pre-rehab images to inform clinical decisions, which greatly improve rehab care after the initial treatment for acutely injured patients. Our study links the quantitative morphological features closely to rehab outcomes after injury, which provide guidance on personalized impatient rehabilitation for acutely injured trauma patients tailored individually according to their clinical history and morphomics factors.