6 research outputs found
Adherence to Guidelines for Acute Rehabilitation in the Norwegian Trauma Plan.
Objective: To evaluate adherence to 3 central operational recommendations for acute rehabilitation
in the Norwegian trauma plan.
Methods: A prospective multi-centre study of 538
adults with moderate and severe trauma with New
Injury Severity Score >9.
Results: Adherence to the first recommendation,
assessment by a physical medicine and rehabilitation physician within 72 h following admission to
the intensive care unit (ICU) at the trauma centre,
was documented for 18% of patients. Adherence to
the second recommendation, early rehabilitation in
the intensive care unit, was documented for 72%
of those with severe trauma and ≥2 days ICU stay.
Predictors for early rehabilitation were ICU length
of stay and spinal cord injury. Adherence to the
third recommendation, direct transfer of patients
from acute ward to a specialized rehabilitation unit,
was documented in 22% of patients, and occurred
more often in those with severe trauma (26%), spinal cord injury (54%) and traumatic brain injury
(39%). Being employed, having head or spinal
chord injury and longer ICU stay were predictors for
direct transfer to a specialized rehabilitation unit.
Conclusion: Adherence to acute rehabilitation guidelines after trauma is poor. This applies to documented early assessment by a physical medicine
and rehabilitation physician, and direct transfer
from acute care to rehabilitation after head and
extremity injuries. These findings indicate a need
for more systematic integration of rehabilitation in
the acute treatment phase after trauma
Modelling human choices: MADeM and decision‑making
Research supported by FAPESP 2015/50122-0 and DFG-GRTK 1740/2. RP and AR are also part of the Research, Innovation and Dissemination Center for Neuromathematics FAPESP grant (2013/07699-0). RP is supported by a FAPESP scholarship (2013/25667-8). ACR is partially supported by a CNPq fellowship (grant 306251/2014-0)