title: The severe traumatic brain injury in Austria: early rehabilitative treatment and outcome.
abstract: BACKGROUND
  Severe traumatic brain injury (TBI) is a great economical and logistic problem in the health care system which reduces the quality of life and productivity of the patient. The purpose of this study is to evaluate the outcome of patients after severe brain trauma according to the course of their rehabilitation.
  
  
  METHODS
  Patients with TBI were divided into three groups. Group A; after early rehabilitation (n = 16), B; following a standard rehabilitation procedure after work accidents (n = 34) and C; undergone standard rehabilitation procedure after accidents at home (n = 12). Glasgow Coma Scale (GCS), Post traumatic amnesia (PTA) during acute care, Glasgow Outcome Scale Extended (GOSE) and Functional Independence Measurement (FIM) were measured before and after rehabilitation. Long-term outcomes (12 months post injury) were measured with the Community Integration Questionnaire (CIQ).
  
  
  RESULTS
  Group A showed a significantly shorter time span from hospital admission until rehabilitation center admission than B and C (p < 0.001). PTA was significantly lower in group B than in group A (p = 0.038). GOSE of patients within group C was significantly lower (p = 0.004) at hospital discharge. FIM was significantly higher in B (p = 0.005) at the time of admission to rehabilitation center. At the time of discharge FIM showed no significant differences between the groups. CIQ showed a trend to improving scores in group A.
  
  
  CONCLUSIONS
  Despite the similar level of severity of TBI and outcome prognosis group A showed the best rehabilitation effect and long-term outcome.
authors.affiliation: Department of Anesthesia, Trauma Hospital Vienna South, Kundratstraße 37, Vienna, 1120 Austria.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Steiner
authors.affiliation: Department of Neuro-Rehabilitation, Rehabilitation Center for traumatic brain injury patients-Vienna-Meidling, Köglergasse 2a, Vienna, 1120 Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Murg-Argeny
authors.affiliation: Department of Anesthesia, Trauma Hospital Vienna South, Kundratstraße 37, Vienna, 1120 Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Steltzer
keywords: Early rehabilitation; Length of stay; Outcome; Quality of life; Severe traumatic brain injury