Rehabilitation after severe traumatic brain injury. A national multicentre study

In Norway, the annual rate of hospital admission caused by head trauma is around 200 per 100 000 inhabitants. About 15 % of the patients admitted to a neurosurgical department with traumatic brain injury, are in the severe group according to the Glasgow C oma Scale score. These patients demand intensive medical care as well as comprehensive rehabilitation. Return to daily life and participation in work and social activities pose a challenge. A report from the Directory of Social and Health Affairs in Norwa y recommends to reinforce the rehabilitation offered to patients with traumatic brain injury. Presently the content and organisation of the rehabilitation varies between the regions. Well organised early introduced rehabilitation as well as genetic factor s is assumed to be of importance for complications and outcome even though scientific evidence is lacking. Hence, this project is a prospective multicenter study, comprising of all patients admitted with severe traumatic brain injury to the regional hospi tals in all health regions, over 2 years, with a follow up period of 1 year. Registrations in the acute phase comprise demographic data, causes of injury, level of consciousness, medical data and complications. MR of the brain and blood test for APOE4 are performed. The organisation and content of the rehabilitation are recorded. Internationally accepted outcome measurements regarding function, symptoms and quality of life are used at 3 and 12 monts post-injury. Incidence of traumatic brain injury will b e estimated for adults and children. Regional differences in organisation and content of treatment and rehabilitation will be assessed. Demographic, genetic (apoEe4), medical, as well as specialized rehabilitation introduced early or later and the extent of waiting periods will be analysed with respect to complications, level of functioning, need of personal assistance and participation in social and occupational life.