Abstract
BackgroundSevere traumatic brain injury (TBI) is a great economical and logistic problem in the health care system which reduces the quality of life and productivity of the patient. The purpose of this study is to evaluate the outcome of patients after severe brain trauma according to the course of their rehabilitation.MethodsPatients with TBI were divided into three groups. Group A; after early rehabilitation (n = 16), B; following a standard rehabilitation procedure after work accidents (n = 34) and C; undergone standard rehabilitation procedure after accidents at home (n = 12). Glasgow Coma Scale (GCS), Post traumatic amnesia (PTA) during acute care, Glasgow Outcome Scale Extended (GOSE) and Functional Independence Measurement (FIM) were measured before and after rehabilitation. Long-term outcomes (12 months post injury) were measured with the Community Integration Questionnaire (CIQ).ResultsGroup A showed a significantly shorter time span from hospital admission until rehabilitation center admission than B and C (p < 0.001). PTA was significantly lower in group B than in group A (p = 0.038). GOSE of patients within group C was significantly lower (p = 0.004) at hospital discharge. FIM was significantly higher in B (p = 0.005) at the time of admission to rehabilitation center. At the time of discharge FIM showed no significant differences between the groups. CIQ showed a trend to improving scores in group A.ConclusionDespite the similar level of severity of TBI and outcome prognosis group A showed the best rehabilitation effect and long-term outcome.
Highlights
Severe traumatic brain injury (TBI) is a great economical and logistic problem in the health care system which reduces the quality of life and productivity of the patient
There were no significant differences in age and Glasgow Coma Scale (GCS) between the groups
The outcomes of group C are comparable to the findings of Livingston et al [6] who described the hospital outcome using the Glasgow Outcome Scale (GOS) as 4 % favorable, 30 % moderate and 66 % unfavorable
Summary
Severe traumatic brain injury (TBI) is a great economical and logistic problem in the health care system which reduces the quality of life and productivity of the patient. The purpose of this study is to evaluate the outcome of patients after severe brain trauma according to the course of their rehabilitation. The increasing survival rate implies a rise in the number of patients submitted to rehabilitation, which the health care system has to deal with. Low-level falls imply a high risk for elderly people and represent a increasing problem with the further ageing of the western civilization. This issue is even more serious in respect to the long and wearing rehabilitation process [6]. Sanchez et al [7] already reported that falls have become the leading cause of severe TBI in adults, outpacing traffic accidents in Pennsylvanias ageing population
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