Long term results after multiple injuries including severe head injury.
OBJECTIVE
To describe the long term results in patients with multiple injuries including severe head injury.


METHODS
Retrospective and prospective clinical study.


METHODS
Level I trauma centre, Germany.


METHODS
Patients aged 16-60 years who had been injured more than 2 years before, whose Injury Severity Score was over 20 and whose cranial Abbreviated Injury Score (AIS) was over 3.


METHODS
Glasgow Outcome Scale (GOS), functional, neuropsychological, vocational and social outcomes.


RESULTS
58 patients, median age 24 (range 16-53, interquartile range (IQR) 21-32) years were investigated 5 (3-9; IQR 4-7) years after their injury. Median ISS was 34 (21-57; IQR 26-41) and GCS 6 (3-8; IQR 4-7). Duration of coma was 10 (2-51; IQR 7-22) days and neurological rehabilitation lasted 169 (10-830; IQR 80-300) days. Movements of the elbow and ankle was most impaired by injury. All psychometric tests showed deficits, particularly in speed of processing, concentration, recent memory, and learning performance. The social environment had been changed in half and vocational rehabilitation was dependent on age. 24 (42%) returned to their former profession, 18 (31%) were retrained to another profession, 16 (27%) were unemployed or retired on a pension. 31 (53%) made a good recovery with moderate disability, 19 (33%) had severe disability, and 8 (14%) remained in a persistent vegetative state assessed by the GOS.


CONCLUSIONS
Early and concentrated rehabilitation facilitates functional, social, and neuropsychological reintegration.
Lehmann
U
U
Department of Traumatology, Medical School Hannover, Germany.
Pape
H C
HC
Seekamp
A
A
Gobiet
W
W
Zech
S
S
Winny
M
M
Molitoris
U
U
Regel
G
G
D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000209:etiology; D006259:Craniocerebral Trauma / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D004651:Employment; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies