Effectiveness of a community-based 3-year advisory program after acquired brain injury.
Objective of this study was to examine the effectiveness of a coordinated, community based 3-year advisory program in 1534 patients with acquired brain injury. Patients and caregivers were offered a coordinated advisory program after discharge from rehabilitation. Patients in the historical control group received standard aftercare. The main outcomes were functional status [Functional Independence Measure (FIM)], and days spent in the acute hospital. The secondary outcome was survival. Patients were comparable for sex (intervention: 41.3% female, control: 38.0%), and younger in the control group (mean age intervention: 55.3, control: 49.6). Functional status at discharge was lower in the intervention group (mean FIM intervention: 66.2, control: 80.3). Patients in the intervention group experienced a moderate gain in FIM. Rate of days in hospital was 15.4 per 1000 person days (intervention) and 15.5 per 1000 person days (control). Patients of the intervention group had an increased rate of days in hospital. A total of 16.0% of patients in the intervention group and 19.3% in the control group died during follow-up. Patients in the intervention had a significant lower mortality risk depending on follow-up period and discharge FIM. The advisory program may be effective for all patients with acquired brain injury.
Grill
E
E
Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-Universität, Munich, Germany.
Ewert
T
T
Lipp
B
B
Mansmann
U
U
Stucki
G
G
D001930:Brain Injuries / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D015331:Cohort Studies; D003253:Consultants / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012111:Residence Characteristics