Centralized rehabilitation after severe traumatic brain injury--a population-based study.
OBJECTIVE
To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation.


METHODS
Prospectively, the most severely injured group of adults from an uptake area of 2.4 million in Denmark were included at admission to a regional brain injury unit (BIU), on average 19 days after injury. Patients in the retrospective study used for comparison were randomly chosen from the national hospital register.


CONCLUSIONS
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.
Engberg
A W
AW
Department of Neurological Rehabilitation, Brain Injury Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark. aae@dadlnet.dk
Liebach
A
A
Nordenbo
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001930:Brain Injuries / Q000145:classification / Q000473:pathology / Q000534:rehabilitation*; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012046:Rehabilitation / Q000379:methods / Q000458:organization & administration*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome