Identifying clinical complexity in patients affected by severe acquired brain injury in neurorehabilitation: a cross sectional survey

Autor: Scarponi F., Zampolini M., Zucchella C., Bargellesi S., Fassio C., Pistoia F., Bartolo M, Raggi R, Beatrici M, Macchetta C, Cocchini L, Benedetti A, Bianconi F, Bramanti P, Marino S, Corallo F, Brambilla M, Carboncini M C., Spina V, Cervigni G, Cimenti F, Previaio C, Semerjian M, Colombari M, De Cicco D, De Tanti A, Iardella L, Diverio M), Grifoni C, Carl V, Pasqualone E, Estraneo A, Formisano R, Ciurli M P., Galardi M, Santangelo A, Giorgini T, Biasutti E, Iaia V, Intiso D, Lamberti G, Antoniono E, Lanfranchi M, Lavezzi S, Chiavaroli R, Lucca L F., Maggioni G, Mancuso M, Canova S, Mandala G, Melizza G, Montis A, Pilia F, Mulè C., Navarro J, Lanzillotti C, Perin C, Petrozzino S, Schierano G, Battistini A, Premoselli S, Salvi P, Simonini M, Sara M Pardo M, Serafini P, Fortuna R, Sergio M A., Volanti P
Přispěvatelé: Scarponi, F, Zampolini, M, Zucchella, C, Bargellesi, S, Fassio, C, Pistoia, F, Bartolo, M, Raggi, R, Beatrici, M, Macchetta, C, Cocchini, L, Benedetti, A, Bianconi, F, Bramanti, P, Marino, S, Corallo, F, Brambilla, M, Carboncini M, C, Spina, V, Cervigni, G, Cimenti, F, Previaio, C, Semerjian, M, Colombari, M, De Cicco, D, De Tanti, A, Iardella, L, Diverio, M, Grifoni, C, Carl, V, Pasqualone, E, Estraneo, A, Formisano, R, Ciurli M, P, Galardi, M, Santangelo, A, Giorgini, T, Biasutti, E, Iaia, V, Intiso, D, Lamberti, G, Antoniono, E, Lanfranchi, M, Lavezzi, S, Chiavaroli, R, Lucca L, F, Maggioni, G, Mancuso, M, Canova, S, Mandala, G, Melizza, G, Montis, A, Pilia, F, Mulè, C, Navarro, J, Lanzillotti, C, Perin, C, Petrozzino, S, Schierano, G, Battistini, A, Premoselli, S, Salvi, P, Simonini, M, Sara, M, Serafini, P, Fortuna, R, Sergio M, A, Volanti, P
Rok vydání: 2019
Předmět:
Patient admission
Male
030506 rehabilitation
medicine.medical_specialty
Cross-sectional study
medicine.medical_treatment
Population
Glasgow Outcome Scale
Physical Therapy
Sports Therapy and Rehabilitation
Comorbidity
Brain injuries
Rehabilitation Centers
Brain injurie
Disability Evaluation
03 medical and health sciences
0302 clinical medicine
Acute care
medicine
Humans
education
Paroxysmal sympathetic hyperactivity
Acquired brain injury
Neurorehabilitation
Cross-Sectional Studie
Rehabilitation Center
Inpatients
Health Services Needs and Demand
education.field_of_study
Rehabilitation
business.industry
Neurological Rehabilitation
Middle Aged
medicine.disease
Brain Injuries
Cross-Sectional Studies
Female
Physical therapy
Inpatient
0305 other medical science
business
030217 neurology & neurosurgery
Human
Zdroj: European Journal of Physical and Rehabilitation Medicine. 55
ISSN: 1973-9095
1973-9087
DOI: 10.23736/s1973-9087.18.05342-x
Popis: Background Literature shows that occurrence of comorbidities in people with severe acquired brain injury (sABI) is a common problem in rehabilitation stay. Consequently, patients could require an increase of interventions for diagnosis and treatment of clinical conditions, with a reduction of the rehabilitative take in charge for both clinical and organizational aspects. Aim The first aim was to evaluate the rate of clinical conditions of sABI patients at admission in rehabilitation and the types of rehabilitative interventions performed in the first week; second objective was to explore the impact of clinical conditions on real rehabilitative take in charge. Design Cross sectional study. Setting Inpatient rehabilitation centers. Population The study included data from 586 sABI patients. Methods Collected data regarded anamnestic information, functional status assessed by means of Glasgow Outcome Scale, Levels of cognitive functioning, Early Rehabilitation Barthel Index, comorbidities at admission and type of rehabilitative interventions carried out in first week of rehabilitation stay. Spearman correlation coefficients were applied to detect possible correlations between the number of treatments in first week and clinical variables; through a multiple regression analysis the effect of patient's characteristics on rehabilitative take in charge was explored. Results Data from the sABI patients: mean age 55.1±17.1 years; etiology of sABI was vascular in 315 patients (53.8%), anoxic in 83 (14.2%), neoplastic in 17 (2.9%), infectious in 15 (2.6%), traumatic in 150 (25.6%); 6 subjects (1%) presented a mixed etiology. Need of cardiorespiratory monitoring, pressure sores, infections or presence of multi drug resistant bacteria were the most frequent comorbidities. Passive mobilization, sitting positioning, arousal/awareness stimulation, evaluation and management of dysphagia were the interventions most frequently carried out in the first week. The regression analysis showed that severe neurological and clinical conditions, acute organ failure, cardio-respiratory instability and paroxysmal sympathetic hyperactivity significantly limit access to rehabilitative sessions. Conclusions In sABI patients clinical comorbidities requiring elevated care assistance are frequent at admission in rehabilitation from acute wards and may interfere with rehabilitative take in charge. Clinical rehabilitation impact The knowledge of clinical complexity of sABI patients may improve their care pathways, promoting early and appropriate transition from acute care to rehabilitation settings.
Databáze: OpenAIRE
Externí odkaz: