Factors predicting functional and cognitive recovery following severe traumatic, anoxic, and cerebrovascular brain damage

Abstract 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.