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颅脑创伤后康复:参与 CENTER-TBI 研究的 70 个欧洲神经创伤中心的调查。

Rehabilitation after traumatic brain injury: A survey in 70 European neurotrauma centres participating in the CENTER-TBI study.

机构信息

Center for Medical Decision Sciences, Department of Public Health, Erasmus MC, 3015CN Rotterdam, The Netherlands.

出版信息

J Rehabil Med. 2017 May 16;49(5):395-401. doi: 10.2340/16501977-2216.

Abstract

OBJECTIVE

To describe variation in structural and process characteristics of acute in-hospital rehabilitation and referral to post-acute care for patients with traumatic brain injury across Europe.

DESIGN

Survey study, of neurotrauma centres.

METHODS

A 14-item survey about in-hospital rehabilitation and referral to post-acute care was sent to 71 neurotrauma centres participating in a European multicentre study (CENTER-TBI). The questionnaire was developed based on literature and expert opinion and was pilot-tested before sending out to the centres.

RESULTS

Seventy (99%) centres in 20 countries completed the survey. The included centres were predominately academic level I trauma centres. Among the 70 centres, a multidisciplinary rehabilitation team can be consulted at 41% (n = 29) of the intensive care units and 49% (n = 34) of the wards. Only 13 (19%) centres used rehabilitation guidelines in patients with traumatic brain injury. Age was reported as a major determinant of referral decisions in 32 (46%) centres, with younger patients usually referred to specialized rehabilitation centres, and patients ≥ 65 years also referred to nursing homes or local hospitals.

CONCLUSION

Substantial variation exists in structural and process characteristics of in-hospital acute rehabilitation and referral to post-acute rehabilitation facilities among neurotrauma centres across Europe.

摘要

目的

描述欧洲创伤性脑损伤患者在院急性期康复和向急性后康复机构转诊的结构和过程特征的差异。

设计

神经创伤中心的调查研究。

方法

对参与欧洲多中心研究(CENTER-TBI)的 71 个神经创伤中心进行了一项关于院内康复和向急性后康复机构转诊的 14 项调查。该问卷是基于文献和专家意见制定的,并在发给中心之前进行了试点测试。

结果

20 个国家的 70 个(99%)中心完成了调查。纳入的中心主要是一级创伤学术中心。在 70 个中心中,有 41%(n=29)的重症监护病房和 49%(n=34)的病房可以咨询多学科康复团队。只有 13 个(19%)中心在创伤性脑损伤患者中使用康复指南。32 个(46%)中心报告年龄是转诊决策的主要决定因素,年轻患者通常转往专门的康复中心,≥65 岁的患者也转往疗养院或当地医院。

结论

欧洲神经创伤中心在院内急性期康复和向急性后康复机构转诊的结构和过程特征方面存在很大差异。

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