To clarify the outcomes of adults with brain injury and symptomatic epileptic seizure in acute inpatient rehabilitation by pre-admission level of independence.
The study design was a retrospective observational study. The participants were 32 inpatients with symptomatic epileptic seizures and underwent rehabilitation (previous brain lesion: stroke 23, brain tumor 5, trauma 3, and other 1). Data collected from medical records included pre-admission independence (modified Rankin Scale, mRS), motor paralysis (Stroke Impairment Assessment Set-motor item, SIAS-m), presence of moderate or severe dysphagia, Functional Independence Measure (FIM), and discharge destination. The participants were divided into three groups based on their pre-admission level of independence: Group A: mRS 0-2 (independent outdoors), Group B: mRS 3 (independent indoors), and Group C: mRS 4-5 (not independent), and data descriptively analysed accordingly.
The results are presented in order of Group A (n=12, 67±13 years), Group B (n=8, 78±7 years), and Group C (n=12, 78±12 years). At discharge, mRS was 2.5 / 4 / 5, SIAS-m was 25 / 16 / 10.5 (best score: 25), FIM was 78 / 45.5 / 27.5 (best score: 126), moderate or severe dysphagia was present in 17% / 25% / 50%, recurrence occurred in 58% / 42% / 75%, pre-admission home residency was 100% / 75% / 0% and discharge to home was 50% / 37.5% / 0%, respectively. Group A (independent outdoors before admission) comprised younger patients than the other groups. Many of them maintained motor function and independence and were discharged home. Fifty percent, all aged>65, could not be discharged home. Three patients who could not take oral intake were discharged to another hospital or facility. Group B (independent indoors) were older with moderate motor paralysis and most required assistance with indoor ADLs. More than half were discharged to places other than home, while all 3 patients discharged home could take oral intake. Group C (non-independent) comprised older patients, many of whom had severe motor paralysis and dysphagia due to recurrent seizures. All were admitted from a facility and discharged to a facility or long-term care hospital.
The outcomes of acute rehabilitation for adults with symptomatic epileptic seizure in acute inpatient rehabilitation are mainly influenced by pre-admission independence, age, and oral feeding ability.
This study contributes to the prediction of outcomes in acute-phase rehabilitation for adults with symptomatic epileptic seizure.
pre-admission independence
dysphagia
