title: Hydrocephalus during rehabilitation following severe TBI. Relation to recovery, outcome, and length of stay.
abstract: BACKGROUND
  Post traumatic hydrocephalus (PTH) is a frequent complication during rehabilitation following severe TBI. However, the diagnosis of PTH is not straightforward and despite shunting recovery may be delayed.
  
  
  OBJECTIVE
  To study the influence of PTH on recovery and outcome during rehabilitation.
  
  
  METHODS
  We studied 417 patients with severe TBI admitted consecutively to a single hospital-based neurorehabilitation department serving Eastern Denmark between 2000 and 2010. Demographics (age and gender) and clinical characteristics (length of acute treatment, post traumatic amnesia (PTA), level of consciousness, injury severity (ISS), and admission FIM™), and PTH were related to recovery (discharge FIM™), outcome (GOS), and length of rehabilitation stay.
  
  
  RESULTS
  Patients with PTH were older, brain injury more severe, and acute treatment was longer. At discharge they had more disability, longer rehabilitation stays, and unfavorable outcome. However, after adjusted multiple regression analyses PTH was not associated with disability at discharge or outcome. Instead, PTH was associated with longer stay for rehabilitation.
  
  
  CONCLUSIONS
  Shunting for PTH does not affect recovery and outcome per se, but prolongs lengths of stay by almost 3 weeks. Therefore, patients treated for PTH are as likely to benefit from rehabilitation as patients without, but require longer rehabilitation stays.
authors.affiliation: Research Unit on Brain Injury Rehabilitation, Copenhagen (RUBRIC), Denmark Department of Neurorehabilitation, TBI Unit. Copenhagen University Hospital of Glostrup, Denmark.
authors.forename: Mia
authors.initials: M
authors.lastname: Linnemann
authors.affiliation: Research Unit on Brain Injury Rehabilitation, Copenhagen (RUBRIC), Denmark Department of Neurorehabilitation, TBI Unit. Copenhagen University Hospital of Glostrup, Denmark.
authors.forename: Maiken
authors.initials: M
authors.lastname: Tibæk
authors.affiliation: Research Unit on Brain Injury Rehabilitation, Copenhagen (RUBRIC), Denmark Department of Neurorehabilitation, TBI Unit. Copenhagen University Hospital of Glostrup, Denmark.
authors.forename: Lars Peter
authors.initials: LP
authors.lastname: Kammersgaard
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D003243:Consciousness; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000534:rehabilitation*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D020127:Recovery of Function; D012044:Regression Analysis; D016896:Treatment Outcome
keywords: Brain injury; hydrocephalus; outcome; prediction; rehabilitation; traumatic