The effect of etiological and clinical characteristics on the rehabilitation process and functional gains in pediatric severe acquired brain injury.

Abstract

Objectives: The aim of this study was to investigate the etiological and clinical characteristics of pediatric patients with severe acquired brain injury and their effects on rehabilitation outcomes.

Patients and methods: A total of 67 pediatric patients (39 males, 28 females; mean age: 9.7±4.8 years; range, 3 to 18 years) who were hospitalized due to severe acquired brain injury between March 2020 and October 2021 were retrospectively analyzed. The patients were classified in five different groups according to the etiology: traumatic brain injury, anoxic brain injury (ABI), cerebrovascular accident, encephalitis, and brain tumors. The time of brain injury, etiology, length of stay in the intensive care unit, additional injuries, presence of operation, nutritional status, history of tracheotomy, duration of rehabilitation and complications were recorded. The factors affecting the difference between the Functional Ambulation Classification (FAC) scores of the patients before and after rehabilitation were evaluated.

Results: The mean time since injury was 83.04±57.29 days and the mean duration of rehabilitation was 55.37±37.15 days. Statistically significant improvements were found in all the groups in the functional levels and FAC scores after rehabilitation. In the inter-group comparisons, the ABI group showed statistically less improvement than the other groups. The functional level of the patients before rehabilitation, etiology and the presence of fecal incontinence were statistically significant factors that affected the change in FAC scores (p=0.043, p=0.049, p=0.048, and p=0.035, respectively).

Conclusion: Our study results show that rehabilitation yields in positive outcomes even in patients with severely acquired brain injury in the pediatric age group.