Centralized rehabilitation after severe traumatic brain injury - a population-based study

Abstract

Out of 117 patients in the prospective study, six died, and 92 (1.27 per 100,000 population per year) survived after a post-traumatic amnesia (PTA) period of at least 28 days. All 19 patients with PTA 7-27 days and 48% of survivors with PTA at least 4 weeks were discharged directly home. The incidence of patients vegetative at 1 month post-trauma was 0.29, and at 1 year 0.055 per 100,000 population. By comparison of 39 patients from the centralized unit injured in 2000-2003 with 21 patients injured in 1982, 1987 or 1992 and with similar PTA- and age distributions and male/female ratio, Glasgow Outcome Scale score at discharge was significantly better for the former group.

Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates

“…This is in agreement with the recent study by Trivedi et al also using SIENA (Trivedi et al, 2007). While our patient population represented very severely injured survivors of TBI (Engberg et al, 2006), Trivedi studied a population of mixed injury severity ranging from mild to severe TBI. This probably explains why we found a greater decline in brain volume (mean −4.0%, median −2.9%) compared to their study (mean −1.43%).…”

Does an Early Onset and Continuous Chain of Rehabilitation Improve the Long-Term Functional Outcome of Patients with Severe Traumatic Brain Injury?

“…According to recent research, rehabilitation after severe TBI should start in the acute phase of hospital care to optimize patients' outcomes and recovery potential (Khan et al, 2002). There have been several studies of early rehabilitation after severe TBI that support the benefit of early interventions (Engberg et al, 2006;Greenwood et al, 2004;Mackay et al,1992;Mammi et al, 2006;Sorbo et al, 2005). Mackay and associates (1992) concluded that ''aggressive rehabilitation during acute hospitalization'' contributed to a shorter total rehabilitation stay for the group that received acute rehabilitation.…”

“…A Swedish study (Sorbo et al, 2005) concluded that an effective combination of medical and rehabilitation efforts resulted in shorter hospital stays and produced a good outcome/living situation for patients with severe brain damage (TBI or subarachnoid hemorrhage). A Danish study found that centralized rehabilitation after severe TBI resulted in better outcome compared to historical data from decentralized rehabilitation (Engberg et al, 2006). These studies were, however, limited by being either non-randomized controlled trials, or by their retrospective/cross-sectional design.…”

“…The program described in this study was based on intervention at the early onset, followed by a continuous chain of treatment. The program was inspired by the centralized TBI rehabilitation program in Denmark (Engberg et al, 2006) and the early formalized rehabilitation program in Sweden (Sorbo et al, 2005). The aim of these programs was to stimulate neuronal reorganization and functional recovery as early as possible.…”

Amnésia pós-traumática: fatores relacionados e qualidade de vida pós-trauma

“…Com TCE (n = 17) ( ± ± ± ± DP) Sem TCE (n = 44) ( ± ± ± ± DP) Diabéticos (n = 27) ( ± ± ± ± DP) Não Diabéticos (n = 157) ( ± ± ± ± DP) Pré-Operatório (n=13) ( ± ± ± ± DP) Pós-Operatório (n=13) ( ± ± ± ± DP) (20,57,(100)(101)(102)(103)(104)(105)(106)(107) .…”