Functional outcome at 1 vs. 2 years after severe traumatic brain injury

The aim of the study was to evaluate the outcome of patients with severe traumatic brain injury (STBI) after 12 and 24 months (Glasgow Coma Scale GCS < or = 8 points for at least 24 hours).

A total of 51 patients underwent a multidisciplinary early rehabilitation treatment until they were discharged from hospital and local ambulatory care was deemed sufficient. The follow-up examination took place 12 and 24 months after the STBI.

Data revealed a high level of independence in activities of daily living (mean Barthel Index after 1 year 92.7 points, after 2 years 93.7 points). After 1 and 2 years, 74.5% and 80.4% of the patients, respectively, were completely independent of need for care. Nevertheless, more than half of the patients had sensorimotor, behavioural, speech, visual and/or auditory disturbances. Return to work rates improved between 1-2 years after trauma, as evidenced by the rate of patients being back to full time work at 1 year (n = 14, 28%) and 2 years (n = 20, 40%) post-STBI; although none of these changes reached statistical significance.

In summary, there are still changes in both impairment and disability related areas between 1-2 years post-STBI, but the degree of improvement is variable depending on the area being considered. Clinicians should remain aware of the fact that modulation of impairment and disability appear to continue well beyond 1 year post-STBI, which may impact on decisions regarding the provision and intensity of further rehabilitation efforts.