title: [Course of rehabilitation in early neurological/neurosurgical rehabilitation. Results of a 2014 multi-center evaluation in Germany].
abstract: BACKGROUND
  In Germany, neurological-neurosurgical early rehabilitation is well established in the treatment of severe neurological diseases. To develop quality standards, knowledge of the current rehabilitation course is required.
  
  
  METHODS
  A retrospective analysis was performed on the course of rehabilitation from patients in an early neurological/neurosurgical rehabilitation program in 16 centers from 10 German states. The odds for a good or poor outcome were investigated using a multivariate logistic regression model.
  
  
  RESULTS
  Seven hundred and fifty-four patients were included in the study. The average age of the patients was 68 ± 15 years. Of the patients studied, 26 % were on mechanical ventilation commencing their neurological rehabilitation. The average duration of stay was 56 ± 51 days. Weaning rate from mechanical ventilation was 65 % and the rate of weaning from tracheal cannula was 54 %. Mean improvement in the Barthel Index of 17 points, significant reduction of dysphagia (from 62 to 30 %) and depended walking (from 99 to 82 %), and the achievement of phase C (the next stage of rehabilitation) in 38 % can still be counted as signs of successful rehabilitation. During their course of stay, near 10 % of the patients died. Of these, 67 % received solely palliative care. In the multivariate logistic models, the absence of the factor "necessity for mechanical ventilation on admission" (odds ratio 0.61; 95 % confidence interval (CI): 0.42 … 0.89) increased the chance for good outcome and the presence of this factor the risk of dying with an odds ratio of 8.07 (95 % CI: 4.54-14.34).
  
  
  CONCLUSIONS
  In spite of the severity of neurological deficits, significant functional progress has been made. These results could be interpret as positive proof of the efficacy of neurological/neurosurgical early rehabilitation programs.
authors.affiliation: Helios Klinik Schloss Pulsnitz, Wittgensteiner Straße 1, 01896, Pulsnitz, Deutschland. Marcus.Pohl@helios-kliniken.de.|Klinik Bavaria Kreischa, Kreischa, Deutschland. Marcus.Pohl@helios-kliniken.de.
authors.forename: M
authors.initials: M
authors.lastname: Pohl
authors.affiliation: Kliniken Schmieder, Heidelberg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Bertram
authors.affiliation: Neurologische Klinik Westend, Bad Wildungen, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Bucka
authors.affiliation: Asklepios Schlossberg Klinik Bad König, Bad König, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Hartwich
authors.affiliation: Brandenburg Klinik, Bernau bei Berlin, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Jöbges
authors.affiliation: Neurologisches Rehabilitationszentrum "Godeshöhe" e. V., Bonn, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Ketter
authors.affiliation: Neurologische Klinik GmbH, Bad Neustadt, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Leineweber
authors.affiliation: Schön Klinik, Bad Aibling, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Mertl-Rötzer
authors.affiliation: HELIOS Klinik Kipfenberg, Kipfenberg, Deutschland.
authors.forename: D A
authors.initials: DA
authors.lastname: Nowak
authors.affiliation: BDH-Klinik Greifswald gGmbH, Greifswald, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Platz
authors.affiliation: Institut für neurorehabilitative Forschung (InFo) der BDH-Klinik Hessisch Oldendorf gGmbH, Assoziiertes Institut der Medizinischen Hochschule Hannover (MHH), Hannover, Deutschland.
authors.forename: J D
authors.initials: JD
authors.lastname: Rollnik
authors.affiliation: Hegau-Jugendwerk, Gailingen, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Scheidtmann
authors.affiliation: Asklepios Kliniken Schildautal, Seesen, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Schön Klinik, Bad Staffelstein, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: von Rosen
authors.affiliation: BDH-Klinik Elzach gGmbH, Elzach, Deutschland.
authors.forename: C W
authors.initials: CW
authors.lastname: Wallesch
authors.affiliation: Neurologisches Rehabilitationszentrum, Leipzig, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Woldag
authors.affiliation: Lehrstuhl für Gesundheitswissenschaften/Public Health, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Peschel
authors.affiliation: Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, Kreischa, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Mehrholz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000401:mortality / Q000534:rehabilitation*; D000066530:Neurological Rehabilitation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000401:mortality / Q000534:rehabilitation*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015300:Ventilator Weaning
keywords: Barthel index; Early neurological and neurosurgical rehabilitation; Long-term rehabilitation course; Neurological rehabilitation Phase B