Department of neurological Rehabilitation, University of Cologne, Germany.
Neurol Neurochir Pol. 2010 Sep-Oct;44(5):475-80. doi: 10.1016/s0028-3843(14)60138-9.
As a result of improvements in the rescue system and progress in intensive care therapy, an increasing number of patients have survived severe traumatic brain injury in recent years. Early and consistent administration of the correct rehabilitation programme is of crucial importance for the restoration and improvement of cerebral function, as well as social reintegration. This prospective study was conducted at the neurosurgical department of a university hospital to assess the one-year outcome of comatose patients after severe traumatic brain injury.
Twenty-seven patients were included. Patients received multimodal early-onset stimulation and continuous inpatient and outpatient rehabilitation therapy. One-year outcome was assessed by means of the Glasgow Outcome Scale, Barthel Index, Functional Independence Measure (FIM) and need of care.
Seven patients died, 4 remained in a vegetative state, 7 were severely disabled, 6 were moderately disabled, and 3 achieved a good recovery 12 months after injury. Median Barthel Index was 65 and median FIM score was 84. The majority of patients were still at least intermittently dependent on care.
Despite intensive rehabilitation treatment, severe traumatic brain injury is still burdened with significant mortality and morbidity.
由于救援系统的改进和重症监护治疗的进步，近年来越来越多的严重创伤性脑损伤患者得以幸存。早期和持续的正确康复方案的管理对于大脑功能的恢复和改善以及社会重新融入至关重要。这项前瞻性研究在一所大学医院的神经外科进行，旨在评估严重创伤性脑损伤后昏迷患者的一年预后。
共纳入 27 名患者。患者接受了多模式早期起始刺激以及持续的住院和门诊康复治疗。采用格拉斯哥预后量表、巴氏指数、功能独立性量表（FIM）和护理需求来评估一年预后。
7 名患者死亡，4 名患者仍处于植物状态，7 名患者严重残疾，6 名患者中度残疾，3 名患者在损伤后 12 个月时恢复良好。中位数巴氏指数为 65，中位数 FIM 评分为 84。大多数患者仍至少间歇性地依赖护理。
尽管进行了强化康复治疗，严重创伤性脑损伤仍然存在显著的死亡率和发病率。
