[Subacute intensive rehabilitation after severe traumatic brain injury. Follow-up 6 months after discharge].
BACKGROUND
In September 2000 the Brain Injury Unit at Hvidovre Hospital was established, offering subacute intensive rehabilitation to patients with severe traumatic brain injury. Uptake area: Eastern part of Denmark, the Faroe Islands and Greenland. Outcome 6 months after discharge is presented for patients from the first 2 years, focusing on disability and social factors.


METHODS
Patients were selected on the basis of the Glasgow Coma Scale after end of sedation to ensure that the most severely-injured were included in the study. Rehabilitation was initiated immediately regardless of the level of consciousness. Patients were assessed using established rating-scales. Local social authorities were involved at discharge.


RESULTS
Of 77 consecutive patients, 5 died before follow-up and 6 patients were not seen at follow up. 79% of the remaining group had post-traumatic amnesia lasting more than 4 weeks. Nonetheless, 4 out of 5 were able to walk independently, 79% were living at home under normal conditions and 76% were independent on a personal level. A majority suffered from cognitive dysfunctions, which was often the major remaining disability. 20% had resumed normal work or education.


CONCLUSIONS
The centralisation of rehabilitation in Denmark after very severe brain damage made it possible to conduct a structured plan for treatment and assessment during subacute rehabilitation and 6 months after discharge of patients with very severe traumatic brain injury. This has demonstrated that rehabilitation of even the most severely brain-damaged patients can be valuable.
Liebach
Annette
A
Hvidovre Hospital, Afdeling for Neurorehabilitering. annette.liebach@hh.hosp.dk
Nordenbo
Annette Mosbaek
AM
Engberg
Aase Worsaae
AW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000647:Amnesia / Q000175:diagnosis / Q000209:etiology; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D012047:Rehabilitation Centers; D012944:Social Support; D014474:Unconsciousness / Q000175:diagnosis / Q000209:etiology