[Functional outcome at discharge of patients with severe traumatic brain injury admitted to a brain damage unit]

Abstract

Introduction: Severe traumatic brain injuries (TBI) are linked to high morbidity and mortality rates and have important individual and social costs, not only because of the high incidence of deaths they cause but also owing to the large number of individuals who are left with some kind of disability.

Aims: The purpose of this study was to analyse the epidemiological, clinical, functional and rehabilitational aspects of patients with severe TBI admitted to a brain damage unit for neurorehabilitation therapy with special emphasis on the functional outcome at discharge.

Patients and methods: We carried out a descriptive study of patients suffering from TBI admitted to the Brain Damage Unit of the Institut Guttmann hospital between January 2000 and June 2002. We analysed epidemiological (age, sex, cause of the TBI), clinical (aetiology, initial Glasgow Coma Scale --GCS--, motor deficit, type of injury, duration of post-traumatic amnesia), functional (Glasgow Outcome Scale --GOS--, Level of Cognitive Functioning Scale --LCFS-- and Disability Rating Scale --DRS--) variables, in addition to patients' destination on discharge.

Results: Of a total of 174 hospitalised patients, 88.52% were cases of serious TBI, 80% of which involved males, with a mean age of 29.72 years (standard deviation: 12.63), and an average of 99.28 days' hospitalisation (standard deviation: 60.72). Road accidents were the chief cause of the TBI (78%). The most frequent neurological injuries were parenchymatous (68.05%), followed by subarachnoid haemorrhages (40.58%). 87.58% of the patients presented TBI-related complications. Functional improvement at discharge was statistically significant (p < 0.001) as regards the GOS, LCFS and DSR scales, and 87.5% of the patients were able to reintegrate into their home life.

Conclusions: Despite the severity of the sequelae left by serious TBI, the functional outcome at discharge, associated with the high rate of reintegration into home life, justifies admission of these patients to a brain damage unit for neurorehabilitation therapy.