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Early rehabilitation of comatose patients after traumatic brain injury
Affiliations- Department of Neurological Rehabilitation, ANR Bonn, Medical Faculty, University of Cologne, Germany
- Department of Rehabilitation Medicine, 1LF Univerzita Karlova, Praha, Czech Republic
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Abstract
As a result of improvements in the rescue system and progress in intensive care therapy, an increasing number of patients have survived severe traumatic brain injury in recent years. Early and consistent administration of the correct rehabilitation programme is of crucial importance for the restoration and improvement of cerebral function, as well as social reintegration. This prospective study was conducted at the neurosurgical department of a university hospital to assess the one-year outcome of comatose patients after severe traumatic brain injury.
Material and methodsTwenty-seven patients were included. Patients received multimodal early-onset stimulation and continuous inpatient and outpatient rehabilitation therapy. One-year outcome was assessed by means of the Glasgow Outcome Scale, Barthel Index, Functional Independence Measure (FIM) and need of care.
ResultsSeven patients died, 4 remained in a vegetative state, 7 were severely disabled, 6 were moderately disabled, and 3 achieved a good recovery 12 months after injury. Median Barthel Index was 65 and median FIM score was 84. The majority of patients were still at least intermittently dependent on care.
ConclusionsDespite intensive rehabilitation treatment, severe traumatic brain injury is still burdened with significant mortality and morbidity.
Abstract
As a result of improvements in the rescue system and progress in intensive care therapy, an increasing number of patients have survived severe traumatic brain injury in recent years. Early and consistent administration of the correct rehabilitation programme is of crucial importance for the restoration and improvement of cerebral function, as well as social reintegration. This prospective study was conducted at the neurosurgical department of a university hospital to assess the one-year outcome of comatose patients after severe traumatic brain injury.
Material and methodsTwenty-seven patients were included. Patients received multimodal early-onset stimulation and continuous inpatient and outpatient rehabilitation therapy. One-year outcome was assessed by means of the Glasgow Outcome Scale, Barthel Index, Functional Independence Measure (FIM) and need of care.
ResultsSeven patients died, 4 remained in a vegetative state, 7 were severely disabled, 6 were moderately disabled, and 3 achieved a good recovery 12 months after injury. Median Barthel Index was 65 and median FIM score was 84. The majority of patients were still at least intermittently dependent on care.
ConclusionsDespite intensive rehabilitation treatment, severe traumatic brain injury is still burdened with significant mortality and morbidity.
Keywords
rehabilitation, coma, outcome, brain injury
About this articleTitle
Early rehabilitation of comatose patients after traumatic brain injury
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
475-480
Page views
377
Article views/downloads
678
DOI
10.1016/S0028-3843(14)60138-9
Bibliographic record
Neurol Neurochir Pol 2010;44(5):475-480.
Keywords
rehabilitation
coma
outcome
brain injury
Authors
Marcela Lippert-Grüner
