Abstract
Severe acquired brain injuries (sABI) represent one of the main causes of disability and limitation in social life participation that need an intensive rehabilitation approach. The purpose of this study was to identify a possible correlation between different supposed conditioning factors and the efficiency of rehabilitation interventions. In this retrospective study, data were processed regarding 44 patients admitted to a neurorehabilitation department after sABI. A significant correlation with the efficiency of the rehabilitation intervention (expressed as the variation of the Barthel score between discharge and admittance in relation to the duration of the rehabilitative hospitalization) was found for both the etiology of the brain injury (p = 0.023), the precocity of the rehabilitation treatment (p = 0.0475), the presence of a tracheal cannula (p = 0.0084) and forms of nutrition other than oral (p < 0.0001). The results of this study suggest that improving the management of the respiratory system, swallowing and nutritional aspects, and favoring an early and personalized rehabilitation treatment, can help to optimize the overall care of patients suffering from sABI, thus allowing a reduction in complications, improvement in functional recovery and ensuring a better management of economic, social and health resources.
Highlights
A severe acquired brain injury consists of brain damage due to cranioencephalic trauma or other causes that determines a protracted condition of coma and sensorimotor, cognitive or behavioral impairments, leading to disability.Due to the different spectrum of residual impairments and disabilities, and to the different incidence rates in the various age groups, it is important to distinguish between traumatic and non-traumatic brain injuries
The following data was collected for each subject: age, sex, etiology of the brain injury, time between the acute event and the rehabilitative hospitalization, presence of a tracheostomy at admittance, type of nutrition at admittance and discharge, number of infectious episodes that occurred during the hospitalization, score on the Barthel Index at admittance and discharge, and the total duration of the rehabilitative hospitalization
All of the patients admitted in the neurorehabilitation unit of Conselve between January 2015 and June 2020 were enrolled in the retrospective analysis
Summary
Due to the different spectrum of residual impairments and disabilities, and to the different incidence rates in the various age groups, it is important to distinguish between traumatic and non-traumatic brain injuries The latter can originate from brain tumors, cerebral anoxia, severe hemorrhagic syndromes, infections (encephalitis) and toxic-metabolic encephalopathies [1,2]. Those affected require appropriate interventions in the emergency phase, a prompt hospitalization in a suitable location for intensive care and neurosurgical treatments, lasting from a few days to a few weeks (acute phase) [3,4]. The rehabilitation team must carefully assess neurological damage and sensorimotor, cognitive and behavioral impairments, which together significantly affect the functional abilities of the patient, resulting in disabilities of varying severity [8]
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