Article
The influence of medical data on the results of neurorehabilitation in intracranial bleedings
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Authors
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Vincent Hagel
- Uniklinik Ulm, Ulm, Deutschland
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Dieter Woischneck
- Landshut, Deutschland
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Angela Pfaffenzeller
- Heidenheim, Deutschland
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Christian Rainer Wirtz
- Ulm, Deutschland
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Thomas Kapapa
- Ulm, Deutschland
| Published: | June 9, 2017 |
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Outline
Text
Objective: What quality of life could be achieved after intracranial hemorrhage and poor initial situation in correlation with parameters from rehabilitation therapy?
Methods: Data from 115 patients after intracranial haemorrhage (spontaneously and traumatic), all of which had been treated in the same clinic for neurological early rehabilitation were analysed. Patients were consecutively added. All had been initially intubated, ventilated and stayed in coma for at least 24 hours. Data of the early stages in the acute care clinic were compared in the context of a retrospective, descriptive exploratory survey with the coma regression scales and the quality of life measurements of rehabilitation. The study was carried out with the approval of an ethics committee.
Results: 1. The potential for improvement and ultimately reached, functional results declined with increasing age. A significant threshold towards the poorer is reported in multiple scores from an age of 60 years onwards. 2. Clinical parameters predicting a poor functional outcome were a anticoagulative premedication, the coma degree in acute care, the nature and location of the lesion (spontaneous bleeding worse than traumatic; bilateral lesions worst). 3. Similar to age, there was a critical point for the duration of artificial ventilation. From 400 hours upwards, the functional values ??were significantly worse. 4. The rehabilitation potential decreased after a prolonged rehabilitation period of more than 60 days. Initial poorer patients, however, showed a better recovery if the stay in the rehabilitation facility was longer.
Conclusion: Age, cause of bleeding, anticoagulative medication, initial coma grade, intubation, duration of artificial ventilation and length of hospital stay in acute hospital are important predictors of outcome after spontaneous and traumatic intracerebral haemorrhage. Patients with poor initial findings at the beginning of early rehabilitation benefit particularly by a rehabilitation period of more than 60 days.
