The Early Functional Abilities (EFA) scale to assess neurological and neurosurgical early rehabilitation patients

BACKGROUND: It is difficult to assess neurological and neurosurgical early rehabilitation patients comprehensively. Available scales focus on activities of daily living (Barthel (BI) and Early Rehabilitation Barthel Index (ERBI)) or wakefulness (Glasgow Coma Scale (GCS), Coma Remission Scale (CRS)) while cognitive items are missing. METHODS: The Early Functional Abilities (EFA) scale comprises 20 items referring to activities of daily living (ADL), wakefulness and cognitive abilities. To evaluate its validity, n = 623 early neurological and neurosurgical rehabilitation patients (most of them after ischemic stroke or cerebral bleeding) were assessed on admission using the EFA, ERBI, GCS, CRS and measures of morbidity (co-diagnoses). RESULTS: The more co-diagnoses the lower EFA sum scores were obtained (Spearman-Rho r(s) = -0.509, p < 0.001). EFA predicted length of stay (LOS, r(s) = -0.565, p < 0.001) and BI at discharge (r(s) = 0.571, p < 0.001). CONCLUSIONS: The results suggest that EFA is a valid instrument to assess critically ill neurological and neurosurgical early rehabilitation patients. It may be used as a measure of morbidity and a predictor of LOS and outcome. Further studies are strongly encouraged.