• U Lehmann, H C Pape, A Seekamp, W Gobiet, S Zech, M Winny, U Molitoris, and G Regel.
• Department of Traumatology, Medical School Hannover, Germany.
• Eur J Surg. 1999 Dec 1; 165 (12): 1116-20.

ObjectiveTo describe the long term results in patients with multiple injuries including severe head injury.DesignRetrospective and prospective clinical study.SettingLevel I trauma centre, Germany.PatientsPatients aged 16-60 years who had been injured more than 2 years before, whose Injury Severity Score was over 20 and whose cranial Abbreviated Injury Score (AIS) was over 3.Main Outcome MeasuresGlasgow Outcome Scale (GOS), functional, neuropsychological, vocational and social outcomes.Results58 patients, median age 24 (range 16-53, interquartile range (IQR) 21-32) years were investigated 5 (3-9; IQR 4-7) years after their injury. Median ISS was 34 (21-57; IQR 26-41) and GCS 6 (3-8; IQR 4-7). Duration of coma was 10 (2-51; IQR 7-22) days and neurological rehabilitation lasted 169 (10-830; IQR 80-300) days. Movements of the elbow and ankle was most impaired by injury. All psychometric tests showed deficits, particularly in speed of processing, concentration, recent memory, and learning performance. The social environment had been changed in half and vocational rehabilitation was dependent on age. 24 (42%) returned to their former profession, 18 (31%) were retrained to another profession, 16 (27%) were unemployed or retired on a pension. 31 (53%) made a good recovery with moderate disability, 19 (33%) had severe disability, and 8 (14%) remained in a persistent vegetative state assessed by the GOS.ConclusionEarly and concentrated rehabilitation facilitates functional, social, and neuropsychological reintegration.

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