gms | German Medical Science

Results of neurological rehabilitation have been evaluated in elder traumatic brain injury patients.

During 48 months since 1999 in this clinic 360 patients suffering from traumatic brain injury underwent rehabilitation therapy. 78 of them have been at the age of 65 years or older. Functional outcome according to FIM and Barthel score, social integration, medical complications, and predictors of outcome have been evaluated.

The mean duration of neurological rehabilitation in this group was 41.6 days with a range from 16 up to 183 days. Most important complications during rehabilitation were pneumonia, aspiration, cardiac disturbances, and urinary tract infections respectively. On admission 27 patients (37%) needed none or only few help concerning activities of daily living. Those patients could further improve during the rehabilitation therapy. Most of 21 severely injured patients with FIM scores less than 40 on admission did not show significant functional improvement. But two of them recovered well and could care for themselves at time of discharge. Even those patients who did not functionally improve could be discharged in a stabilized medical condition. However in two cases deterioration had to be observed concerning medical condition.

The most important predictor of outcome after neurological rehabilitation of elder traumatic brain injury patients is the functional status ad time of admission. This will influence the possibility of social integration as well as the goal of rehabilitation and the specific rehabilitation program for each individual patient.