Article

PURPOSE: To evaluate epidemiological and clinical data on patients with severe
acquired brain injury (sABI) admitted to rehabilitation units in the first 6
years since the inception of a regional register (2005-2010) in the Emilia-Romagna region (Italy). METHOD: Retrospective multicentre study of a
regional cohort using data from an online regional register (Gravi Cerebrolesioni
Emilia-Romagna - GRACER). The study included 318 patients who suffered sABI
(defined by Glasgow Coma Scale score </=8 recorded in the initial 24 h following
injury), who were admitted to and subsequently discharged from rehabilitation
units. Physical and cognitive functions were evaluated at admission and
discharge. Other data recorded included aetiology, presence of secondary
conditions and need for specific medical support. RESULTS: Three-quarters of
patients displayed improvements in physical and/or cognitive function at
discharge from rehabilitation units, with 71.4% of patients returning home.
Better outcomes at discharge were associated in particular with younger age,
traumatic brain injury (versus non-traumatic), or absence of tracheostomy at
admission. CONCLUSION: The GRACER register is a useful tool for the assessment of
epidemiological and clinical information on sABI patients. In light of the
positive impact on patient outcomes, rehabilitation in specialised units is
highly encouraged and should occur as soon as possible. Implications for
Rehabilitation There is a need for more epidemiological and clinical data
associated with severe acquired brain injury, particular regarding those of
non-traumatic origin. In a retrospective multicentre study of a regional cohort
using data from an online regional register in Italy (GRACER), more than
three-quarters of patients displayed improvements in physical and/or cognitive
function at discharge from the rehabilitation units. Better outcomes at discharge
were associated in particular with younger age, traumatic brain injury (versus
non-traumatic) or absence of tracheostomy at admission. Admission to a
specialised rehabilitation unit is highly encouraged for patients with severe
acquired brain injury, and should occur as soon as possible. Policy-makers and
service planners should continue to develop strategies and allocate adequate
resources for rehabilitation services due to their positive impact on patient
outcomes. In particular, patients with conditions associated with increased
likelihood of poor outcomes may require special attention during rehabilitation
to improve outcomes at discharge.

Langue : ANGLAIS