Early intervention in severe head injury: long-term benefits of a formalized program.
With traumatic brain injuries numbering more than two million per year, health professionals are faced with the challenges of restoring and maximizing quality of life. This study quantifies the benefits of a formalized head injury program, including the concept of trauma rehabilitation, defined as early, aggressive rehabilitation during acute hospitalization. Thirty-eight severely head injured patients received treatment at the same rehabilitation facility. Twenty-one of these patients received acute care services at ten different hospitals without formalized traumatic brain injury programs, and 17 received services at a hospital with a formalized early intervention program. Comparison of outcome data for the two programs revealed that patients in the formalized program had comas and rehabilitation stays approximately one third the length of patients in nonformalized programs (18.9 vs 53.8 days and 106.5 vs 239.5 days, respectively). Mean cognitive levels at discharge from the acute hospitals (5.6 vs 4.0) and the rehabilitation facility (7.4 vs 6.7) were significantly higher for the formalized program, and they facilitated a significantly higher percentage of discharges to home vs extended care facility (94% vs 57%).
Mackay
L E
LE
Department of Rehabilitation Medicine, Saint Francis Hospital and Medical Center, Hartford, CT 06105.
Bernstein
B A
BA
Chapman
P E
PE
Morgan
A S
AS
Milazzo
L S
LS
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D003071:Cognition; D006259:Craniocerebral Trauma / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012047:Rehabilitation Centers