title: Outcome and prognosis of hypoxic brain damage patients undergoing neurological early rehabilitation.
abstract: BACKGROUND
  The prevalence of patients suffering from hypoxic brain damage is increasing. Long-term outcome data and prognostic factors for either poor or good outcome are lacking.
  
  
  METHODS
  This retrospective study included 93 patients with hypoxic brain damage undergoing neurological early rehabilitation [length of stay: 108.5 (81.9) days]. Clinical data, validated outcome scales (e.g. Barthel Index-BI, Early Rehabilitation Index-ERI, Glasgow Coma Scale-GCS, Coma Remission Scale-CRS), neuroimaging data, electroencephalography (EEG) and evoked potentials were analyzed.
  
  
  RESULTS
  75.3% had a poor outcome (defined as BI <50). 38 (40.9%) patients were discharged to a nursing care facility, 21 (22.6%) to subsequent rehabilitation, 17 (18.3%) returned home, 9 (9.7%) needed further acute-care hospital treatment and 8 (8.6%) died. Barthel Index on admission as well as coma length were strong predictors of outcome from hypoxic brain damage. In addition, duration of vegetative instability, prolongation of wave III in visual evoked potentials (flash VEP), theta and delta rhythm in EEG, ERI, GCS and CRS on admission were related to poor outcome. All patients with bilateral hypodensities of the basal ganglia belonged to the poor outcome group. Age had no independent influence on functional status at discharge.
  
  
  CONCLUSIONS
  As with other studies on neurological rehabilitation, functional status on admission turned out to be a strong predictor of outcome from hypoxic brain damage.
authors.affiliation: Institute for Neurorehabilitation Research (InFo), Medical School Hannover (MHH), BDH-Clinic Hessisch Oldendorf, Greitstr 18-28, 31840, Hessisch Oldendorf, Germany. uteheinz@gmx.net.
authors.forename: Ute E
authors.initials: UE
authors.lastname: Heinz
authors.affiliation: Institute for Neurorehabilitation Research (InFo), Medical School Hannover (MHH), BDH-Clinic Hessisch Oldendorf, Greitstr 18-28, 31840, Hessisch Oldendorf, Germany. prof.rollnik@bdh-klinik-hessisch-oldendorf.de.
authors.forename: Jens D
authors.initials: JD
authors.lastname: Rollnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000473:pathology / Q000503:physiopathology*; D004569:Electroencephalography; D005074:Evoked Potentials, Visual; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies