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Severe traumatic brain injury outcome assessed by a novel scale: a pilot study

Background: Valid and reliable assessment of long term outcome in traumatic brain injury (TBI) survivors is a prerequisite for the evaluation of functional disability and appropriateness of healthcare provision and rehabilitation support. Aim: The aim of the present study was to design a new, time-sparring and relatively simple outcome measurement scale for the evaluation of severe TBI, on aspects of functionality, mobility, psychocognitive status as well as overall quality of life. Method and Material: The present is a retrospective study that was carried out from February to June 2010. The cohort consisted of 96 patients that were hospitalized due to severe TBI at the University Neurosurgery Clinic of β€œEvaggelismos Hospitalβ€œ, from February 1999 until June 2009. The proposed β€œAthens Disability Scaleβ€œ (ADS) - which combines selected elements of commonly used outcome scales – allows, as a pilot research, the quick (5-7 minutes) assessment of TBI outcome on motor, psycho-cognitive and social aspects by evaluating ten elements. The scale was applied on the cohort by telephone interview. The statistical analysis of the data was accomplished with the SPSS 16.0 for Windows. Results: The study highlighted statistically significant associations between the total ADS score and the following parameters: GCS score, physiotherapy duration, physiotherapy treatment, presence of post-traumatic epileptic seizures and use of antiepileptic medication. No statistically significant relations between the total ADS score and gender, age, injury mechanism or the elapsed time between admission and interviews, were identified. Multivariate linear regression method showed that increased GCS score, decreased physiotherapy duration and absence of post-traumatic epileptic seizures were independently associated with increased total ADS score. A statistically significant association was found between the ability to work and verbal expression, verbal comprehension, mobility, physiotherapy as well as presence of epileptic seizures. Conclusion: The present findings indicate that ADS, as a pilot, represents a useful outcome measurement tool that allows for the rapid assessment of functional disability and quality of life in TBI survivors, in which nurses should also take part.

Author(s): Dimitrouli Aikaterini

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