Abstract for presentation at 6th World Congress on Brain Injury

Study objective
To present results from the first three years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to demonstrate advantages of centralized versus decentralized rehabilitation.
Setting
Regional Brain Injury Unit for centralized rehabilitation based on an uptake area of 2.4 million inhabitants in Denmark.
Design
Prospective, population-based observational study. Comparison of outcome at discharge from the specialized Brain Injury Unit with an earlier study of patients undergoing decentralized rehabilitation.
Patients
On average 18 days of injury, we prospectively included the most seriously head injured 117 patients aged 15 years or more at injury and admitted October 1st, 2000 to end of September 2003.
Main Outcome measures
Incidence, Length of Stay, Post Traumatic Amnesia (PTA), Rancho Los Amigos scores, Functional Independence Measure, Injury Severity Score, Glasgow Outcome scores and discharge destinations. Comparison of Glasgow Outcome Score for recent and historic patient groups with identical PTA distributions.
Results and conclusion
Out of 117 patients, six died, and 92 (1.27 per 100,000 population per year) were discharged alive after a PTA period of at least 28 days. For another 19 PTA was 7-27 days. The incidence of patients vegetative at one month post trauma was 2.9 per million population (pmp) per year, of whom 0.55 pmp per year were still alive as vegetative one year after injury. Mean length of stay under rehabilitation was 115 days. 52% were discharged directly home as personally independent. Another 32% were transferred to non-hospital rehabilitation, 5.1% to nursing homes, and 3.4% to psychiatric wards. By comparison of GOS at discharge for 39 patients from the centralized unit, injured in 2000 – 2003 with 21 patients with the same PTA-range, but injured in 1982, 1987 and 1992, GOS at discharge was significantly better for the group undergoing centralized rehabilitation.