Score on Coma Recovery Scale-Revised at admission predicts outcome at discharge in intensive rehabilitation after severe brain injury

Portaccio, Emilio ¹Morrocchesi, Azzurra ¹Romoli, Anna Maria ¹Hakiki, Bahia ¹Taglioli, Maria Pia ¹Lippi, Elena ¹Di Renzone, Martina ¹Grippo, Antonello ¹Macchi, Claudio¹

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作者信息

1. IRCCS Don Gnocchi Fdn, Intens Rehabil Unit, Florence, Italy
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Abstract

Objective: To assess the prognostic utility of the Coma Recovery Scale-Revised (CRS-R) in rehabilitation of patients surviving from severe brain injury.Methods: In this prospective cohort study, all patients consecutively admitted to an Italian Intensive Rehabilitation Unit, with a diagnosis of unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS) due to acquired brain injury, underwent clinical evaluations using the Italian version of the CRS-R. At discharge, patients transitioning from UWS to MCS or emergence from MCS (E-MCS) and from MCS to E-MCS were classified as improved responsiveness (IR). Score on the Glasgow Outcome Scale (GOS) at discharge was recorded.Results: In total, 137 (66 UWS, 71 MCS) subjects were enrolled. After a mean hospital stay of 5.32.9months, 81 (59.1%) patients achieved an IR. In the multivariable analysis, IR was associated with higher CRS-R score at admission (p=0.002) and younger age at injury (p=0.010). Moreover, higher GOS scores at discharge were related to younger age at injury (p=0.018), shorter time post-onset (p=0.003) and higher CRS-R score at admission (p<0.001).Conclusions: Higher CRS-R scores at admission in intensive rehabilitation unit can help differentiate patients with better outcome at discharge, providing information for rehabilitation planning and communication with patients and their caregivers.

Key words

Coma Recovery Scale-Revised/intensive rehabilitation/severe brain injury/prognosis

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出版年

2018

Brain injury

SCI

ISSN：0269-9052

被引量19

参考文献量35

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