[Course of rehabilitation in early neurological/neurosurgical rehabilitation. Results of a 2014 multi-center evaluation in Germany]. / Rehabilitationsverlauf von Patienten in der neurologisch-neurochirurgischen Frührehabilitation.
Nervenarzt
; 87(6): 634-44, 2016 Jun.
Article
em De
| MEDLINE
| ID: mdl-27090897
ABSTRACT
BACKGROUND:
In Germany, neurological-neurosurgical early rehabilitation is well established in the treatment of severe neurological diseases. To develop quality standards, knowledge of the current rehabilitation course is required. PATIENTS ANDMETHODS:
A retrospective analysis was performed on the course of rehabilitation from patients in an early neurological/neurosurgical rehabilitation program in 16 centers from 10 German states. The odds for a good or poor outcome were investigated using a multivariate logistic regression model.RESULTS:
Seven hundred and fifty-four patients were included in the study. The average age of the patients was 68 ± 15 years. Of the patients studied, 26â¯% were on mechanical ventilation commencing their neurological rehabilitation. The average duration of stay was 56 ± 51 days. Weaning rate from mechanical ventilation was 65â¯% and the rate of weaning from tracheal cannula was 54â¯%. Mean improvement in the Barthel Index of 17 points, significant reduction of dysphagia (from 62 to 30â¯%) and depended walking (from 99 to 82â¯%), and the achievement of phase C (the next stage of rehabilitation) in 38â¯% can still be counted as signs of successful rehabilitation. During their course of stay, near 10â¯% of the patients died. Of these, 67â¯% received solely palliative care. In the multivariate logistic models, the absence of the factor "necessity for mechanical ventilation on admission" (odds ratio 0.61; 95 % confidence interval (CI) 0.42 0.89) increased the chance for good outcome and the presence of this factor the risk of dying with an odds ratio of 8.07 (95 % CI 4.54-14.34).DISCUSSION:
In spite of the severity of neurological deficits, significant functional progress has been made. These results could be interpret as positive proof of the efficacy of neurological/neurosurgical early rehabilitation programs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Neurocirúrgicos
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Reabilitação Neurológica
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Doenças do Sistema Nervoso
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
De
Ano de publicação:
2016
Tipo de documento:
Article