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Factors Predicting Functional and Cognitive Recovery Following Severe Traumatic, Anoxic, and Cerebrovascular Brain Damage

Smania, Nicola MD; Avesani, Renato MD; Roncari, Laura MD; Ianes, Patrizia OT; Girardi, Paolo PhD; Varalta, Valentina Psy; Gambini, Maria Grazia Psy; Fiaschi, Antonio MD; Gandolfi, Marialuisa PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

The Journal of Head Trauma Rehabilitation: March/April 2013 - Volume 28 - Issue 2 - p 131–140
doi: 10.1097/HTR.0b013e31823c0127
Original Articles

Objectives: To compare demographic data, clinical data, and rate of functional and cognitive recovery in patients with severe traumatic, cerebrovascular, or anoxic acquired brain injury (ABI) and to identify factors predicting discharge home.

Participants: Three hundred twenty-nine patients with severe ABI (192 with traumatic, 104 with cerebrovascular, and 33 with anoxic brain injury).

Design: Longitudinal prospective study of inpatients attending the intensive Rehabilitation Department of the “Sacro Cuore” Don Calabria Hospital (Negrar, Verona, Italy).

Main measures: Etiology, sex, age, rehabilitation admission interval, rehabilitation length of stay, discharge destination, Glasgow Coma Scale, Disability Rating Scale (DRS), Glasgow Outcome Scale, Levels of Cognitive Functioning, and Functional Independence Measure.

Results: Predominant etiology was traumatic; male gender was prevalent in all the etiologic groups; patients with traumatic brain injury were younger than the patients in the other groups and had shorter rehabilitation admission interval, greater functional and cognitive outcomes on all considered scales, and a higher frequency of returning home. Patients with anoxic brain injury achieved the lowest grade of functional and cognitive recovery. Age, etiology, and admission DRS score predicted return home.

Conclusions: Patients with traumatic brain injury achieved greater functional and cognitive improvements than patients with cerebrovascular and anoxic ABI. Age, etiology, and admission DRS score can assist in predicting discharge destination.

Department of Neurological, Neuropsychological, Morphological and Movement Sciences (Drs Smania, Roncari, Fiaschi, Varalta, and Gandolfi and Mss Ianes and Varalta), School of Specialization in Physical Medicine and Rehabilitation (Dr Roncari), and Department of Medicine and Public Health, Unit of Epidemiology and Medical Statistics (Dr Girardi), University of Verona; Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC) (Drs Smania and Gandolfi and Mss Ianes and Varalta); Rehabilitation Department, Sacro Cuore Don Calabria, Negrar, Verona (Drs Avesani and Ms Gambini); and IRCCS Ospedale San Camillo Venezia-Lido, Venice (Dr Fiaschi), Italy.

Corresponding Author: Nicola Smania, MD, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, U.S.O. Riabilitazione Neurologica, Azienda Ospedaliera Universitaria Integrata Verona “G.B. Rossi” University Hospital; Via L.A. Scuro, 10, 37134 Verona, Italy (

A grant from the CariVerona Foundation (Mosaico), Verona, Italy, supported this study.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.