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One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study
BACKGROUND: The present study intended to analyze the outcome of patients with severe brain injury one-year after discharge from early rehabilitation. METHODS: Early neurological rehabilitation patients admitted to intensive or intermediate care units and discharged between June 2018 and May 2020 we...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762846/ https://www.ncbi.nlm.nih.gov/pubmed/35039012 http://dx.doi.org/10.1186/s12883-022-02549-w |
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author | Boltzmann, Melanie Schmidt, Simone B. Gutenbrunner, Christoph Krauss, Joachim K. Höglinger, Günter U. Rollnik, Jens D. |
author_facet | Boltzmann, Melanie Schmidt, Simone B. Gutenbrunner, Christoph Krauss, Joachim K. Höglinger, Günter U. Rollnik, Jens D. |
author_sort | Boltzmann, Melanie |
collection | PubMed |
description | BACKGROUND: The present study intended to analyze the outcome of patients with severe brain injury one-year after discharge from early rehabilitation. METHODS: Early neurological rehabilitation patients admitted to intensive or intermediate care units and discharged between June 2018 and May 2020 were screened for eligibility. The level of consciousness was evaluated using the Coma Recovery Scale-Revised (CRS-R) upon admission and at discharge. At one-year follow-up, the outcome was assessed with the Glasgow Outcome Scale-extended (GOSE). Demographical and clinical data collected during inpatient rehabilitation were used to predict the outcome 1 year after discharge. RESULTS: Two hundred sixty-four patients (174 males, 90 females) with a median age of 62 years (IQR = 51–75) and a median duration of their disease of 18 days (IQR = 12–28) were included in the study. At follow-up, the mortality rate was 27% (n = 71). Age and discharge CRS-R total score were independent predictors in a Cox proportional hazards model with death (yes/no) as the dependent variable. According to the GOSE interviews, most patients were either dead (n = 71; 27%), in a vegetative state (n = 28; 11%) or had a severe disability (n = 124; 47%), whereas only a few patients showed a moderate disability (n = 18; 7%) or a good recovery (n = 23; 9%) 1 year after discharge. Age, non-traumatic etiology, discharge CRS-R total score and length of stay independently predicted whether the outcome was good or poor at follow-up. CONCLUSION: Age was an important predictor for outcome at one-year follow-up, which might be due to altered brain plasticity and more comorbidities in elderly subjects. In addition, the present study demonstrated that the CRS-R total score at discharge might be more important for the prediction of one-year outcome than the initial assessment upon admission. |
format | Online Article Text |
id | pubmed-8762846 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87628462022-01-18 One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study Boltzmann, Melanie Schmidt, Simone B. Gutenbrunner, Christoph Krauss, Joachim K. Höglinger, Günter U. Rollnik, Jens D. BMC Neurol Research BACKGROUND: The present study intended to analyze the outcome of patients with severe brain injury one-year after discharge from early rehabilitation. METHODS: Early neurological rehabilitation patients admitted to intensive or intermediate care units and discharged between June 2018 and May 2020 were screened for eligibility. The level of consciousness was evaluated using the Coma Recovery Scale-Revised (CRS-R) upon admission and at discharge. At one-year follow-up, the outcome was assessed with the Glasgow Outcome Scale-extended (GOSE). Demographical and clinical data collected during inpatient rehabilitation were used to predict the outcome 1 year after discharge. RESULTS: Two hundred sixty-four patients (174 males, 90 females) with a median age of 62 years (IQR = 51–75) and a median duration of their disease of 18 days (IQR = 12–28) were included in the study. At follow-up, the mortality rate was 27% (n = 71). Age and discharge CRS-R total score were independent predictors in a Cox proportional hazards model with death (yes/no) as the dependent variable. According to the GOSE interviews, most patients were either dead (n = 71; 27%), in a vegetative state (n = 28; 11%) or had a severe disability (n = 124; 47%), whereas only a few patients showed a moderate disability (n = 18; 7%) or a good recovery (n = 23; 9%) 1 year after discharge. Age, non-traumatic etiology, discharge CRS-R total score and length of stay independently predicted whether the outcome was good or poor at follow-up. CONCLUSION: Age was an important predictor for outcome at one-year follow-up, which might be due to altered brain plasticity and more comorbidities in elderly subjects. In addition, the present study demonstrated that the CRS-R total score at discharge might be more important for the prediction of one-year outcome than the initial assessment upon admission. BioMed Central 2022-01-17 /pmc/articles/PMC8762846/ /pubmed/35039012 http://dx.doi.org/10.1186/s12883-022-02549-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Boltzmann, Melanie Schmidt, Simone B. Gutenbrunner, Christoph Krauss, Joachim K. Höglinger, Günter U. Rollnik, Jens D. One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
title | One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
title_full | One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
title_fullStr | One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
title_full_unstemmed | One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
title_short | One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
title_sort | one-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762846/ https://www.ncbi.nlm.nih.gov/pubmed/35039012 http://dx.doi.org/10.1186/s12883-022-02549-w |
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