Eilander H J, Timmerman R B W, Scheirs J G M, Van Heugten C M, De Kort P L M, Prevo A J H
Rehabilitation Centre Leijpark. Division Research, Project VLB-NAH, Tilburg.
Brain Inj. 2007 Jan;21(1):53-61. doi: 10.1080/02699050601151795.
To investigate the long-term (2-15 years) functional outcome of children and young adults who received an early intensive neurorehabilitation programme (EINP) after a prolonged period of unconsciousness due to severe brain injury; to differentiate between traumatic brain injury (TBI) and non-traumatic brain injury (nTBI); and to compare the results on two different outcome scales: the Disability Rating Scale (DRS) and the Glasgow Outcome Scale Extended (GOSE).
One hundred and forty-five patients, who were admitted to EINP between December 1987 and January 2001.
The Post-Acute Level of Consciousness scale (PALOC-s), the DRS, including categorized scores (DRScat), and the GOSE.
The long-term functional level of 90 patients could be determined, of whom 25 were deceased. The mean DRS-score of the surviving patients was 6.8 (SD = 6.6); the mean score on the GOSE was 4.5 (SD = 1.7). There was a significant difference in the outcome amongst traumatic and non-traumatic patients (t88 = 4.21; p < 0.01). The correlation between the DRS and the GOSE was high (Spearman rho = 0.85; p < 0.01), as well as the correlation between the categorized scores of the DRS and the GOSE (Spearman rho = 0.81; p < 0.01). The distribution of outcome scores on the DRScat is more diverse than on the GOSE. Especially item 7 of the DRS, measuring functional independence, showed considerable variance in discriminating between different outcome levels.
More patients with TBI than expected reached a (semi-) independent level of functioning, indicating a possible effect of EINP. Patients suffering from nTBI did not demonstrate these outcome levels. Only a few patients stayed in a vegetative state for more than a couple of years. In this cohort of severe brain-injured young people, the DRS offered the best investigative possibilities for long-term level of functioning.
调查因严重脑损伤长期昏迷后接受早期强化神经康复计划（EINP）的儿童和青年的长期（2至15年）功能结局；区分创伤性脑损伤（TBI）和非创伤性脑损伤（nTBI）；并比较两种不同结局量表的结果：残疾评定量表（DRS）和扩展格拉斯哥结局量表（GOSE）。
1987年12月至2001年1月期间入住EINP的145名患者。
急性后期意识水平量表（PALOC-s）、DRS，包括分类评分（DRScat）和GOSE。
可确定90名患者的长期功能水平其中25人已死亡幸存患者DRS的平均评分为6.8（标准差=6.6）；GOSE的平均评分为4.5（标准差=1.7）创伤性和非创伤性患者的结局存在显著差异（t88=4.21；p<0.01）DRS与GOSE之间的相关性很高（斯皮尔曼rho=0.85；p<0.01）DRS分类评分与GOSE之间的相关性也很高（斯皮尔曼rho=0.81；p<0.01）DRScat结局评分的分布比GOSE更具多样性尤其是DRS中衡量功能独立性的第7项在区分不同结局水平方面显示出相当大的差异。
达到（半）独立功能水平的TBI患者比预期的多表明EINP可能有效果nTBI患者未表现出这些结局水平只有少数患者处于植物人状态超过几年在这个严重脑损伤的年轻人群体中DRS为长期功能水平提供了最佳的调查可能性。
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