Application of a new rating scale of brain dysfunction to monitoring rehabilitation in 65 patients with severe head injury.

Abstract

Sixty-five patients with severe head injury sustained in motor vehicle accidents (MVA) are the subject of the prospective investigation. For assessment of results of a particular treatment, planning of long-range management and predicting the outcome in terms of employment or of self-care, it is essential to monitor sequentially the progress of recovery. A comprehensive semiquantitative rating Scale g was developed and its application during repeated examinations demonstrated. The Scale g is open-ended, as it allows physicians and investigators in the health field to produce their own schedules of any disability provided that seven levels of that particular dysfunction are defined according to the principles of Scale g. The progress of recovery in motor deficits, dysarthria, mental impairment, and self-care was assessed using appropriate schedules according to Scale g in 65 inpatients at their first admission to the rehabilitation center and at their discharge. The change was made evident by showing patients' advancement, if present, to the higher functional level. It was estimated at the time of discharge that 23.1% can be expected to return to full-time employment, 38.5% are likely to perform part-time lesser work, 13.8% may be able to perform certain, non remunerative chores at home, 24.6% would not be able to do any work--about one-third of them will permanently require long-care facility.