Outcome of prolonged coma following severe traumatic brain injury

Primary objective : To assess the outcome of severe traumatic brain injury 1 year after trauma. Research design : Prospective study conducted at the neurosurgical department of a university hospital. Methods and procedures : A total of 24 patients were included. Outcome was assessed by means of Glasgow outcome scale, Barthel index, Functional independence measure (FIM) and Disability rating scale (DRS). Need of care and job ability were also evaluated. Experimental interventions : Patients received multimodal early-onset stimulation and continuous inpatient and outpatient rehabilitation therapy. Main outcomes and results : Six patients died, three remained in a vegetative state, six were severely disabled, six were moderately disabled and three achieved a good recovery 1 year after injury. Mean Barthel index was 68.9, mean FIM was 88.3 and mean DRS 27.7. The majority of patients still were at least intermittently dependent on care. Most of the trauma survivors were unable to work. Conclusions : Despite intensive rehabilitation treatment, severe traumatic brain injury is still burdened with significant mortality and morbidity.