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European Journal of Physical and Rehabilitation Medicine 2013 June;49(3):365-72


lingua: Inglese

Rehabilitation of acquired brain injuries: a multicentric prospective survey

Zampolini M. 1, Corea F. 1, Avesani R. 2, Boldrini P. 3, De Tanti A. 4, Di Stefano M. G. 5, Formisano R. 6, Lamberti G. 7, Lombardi F. 8, Mazzucchi A. 9, Pistarini C. 10, Taricco M. 11, Citterio A. 12

1 Operative Unit of Severe Acquired Brain Lesions, Asl 3 Umbria, Foligno, Perugia, Italy; 2 Department of Functional Re-education, Don Calabria Hospital, Negrar, Verona, Italy; 3 Operative Unito f rehabilitation Medicine, Ferrara Hospital, Ferrara, Italy; 4 Centro Cardinal Ferrari, Fontanellato, Parma, Italy; 5 Operative Unit of Recovery and Functional Re-education, Cuasso al Monte Hospital, Cuasso al Monte, Varese, Italy; 6 Santa Lucia IRCCS Foundation, Rome, Italy; 7 Structure of Rehabilitation Medicine, Severe Brain Lesions Unit, Caraglio, Cuneo, Italy; 8 Department of Intensive Care Unit, Correggio Hospital, Correggio, reggio Emilia, Italy; 9 ELIAS Neuroriabilitazione, Parma, Italy; 10 Fondazione Clinica del Lavoro S. Maugeri, Montescano, Pavia, Italy; 11 Operative Unit of Rehabilitation Medicine, S. Orsola University Hospitalm, Bologna, Italy; 12 Istituto Mondino, Pavia, Italy


Background: The rehabilitation of the persons with Severe Acquired Brain Injury (ABI) is an important concern to be approached with a comprehensive program aimed to improve the recovery of patients.The efficacy of an early and intensive rehabilitation program has been shown in large number of studies. Few studies focused on the prevalence of TBI and the data are often extrapolated in indirect ways.
Aim: An analysis of the demographic characteristics of the population included in the GISCAR (Gruppo Italiano per lo Studio delle Gravi Cerebrolesioni Acquisite e Riabilitazione- Italian Group for the Study of the severe ABI) database, type and conditions associated to the index event; the treatment administered during hospitalization; and the prognosis according to outcome measures.
Design: The study was an observational prospective survey looking at management of ABI (both traumatic and non-traumatic).
Setting: In hospital rehabilitation.
Population: Patients consecutively admitted in each of the 52 GISCAR centres.
Methods: Every centre included a consecutive cohort and recorded demographic data and index event characteristics.
Results: In the study population were included 2626 subjects suffering of a severe ABI. The difference of length of stay (LOS) was significantly different with 67.5 days for traumatic patients compared to the 80 days of non traumatic ones. In the study population the probability of discharge at home is significantly greater for the traumatic condition (odds ratio 0,4587; CI 0.3671-0.5731). The overall benefit of the rehabilitative treatment was encountered in a net gain in all disability scores taken into account: LCF classes; DRS as well as GOS scores. At discharge the main destination for severe ABI patients was home (67.2%).
Conclusions: A large number of patients admitted in Italian rehabilitative facilities for a severe ABI suffered from a TBI, more often these subjects were young male victims of road accident. The majority of subjects during the rehabilitative hospitalization demonstrated a significant recovery.
Clinical Rehabilitation Impact: Considering the evidence of an early treatment benefit the delay ofthe rehabilitation program start is far from being satisfactory. The high frequency of the home discharge indicate a good compliance of national family network.

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