Citation

Odgaard L, Aadal L, Eskildsen M, Poulsen I. J. Neurosci. Nurs. 2018; 50(3): 149-154.

Affiliation

Questions or comments about this article may be directed to Lene Odgaard, PhD MHS RN, at lene.odgaard@midt.rm.dk. She is Data Manager, Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark. Lena Aadal, PhD MSN RN, is Head of Clinical Nursing Research, Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark. Marianne Eskildsen, is Social and Health Assistant, Department of Neurorehabilitation, Traumatic Brain Injury, Rigshospitalet, Copenhagen University Hospital, Hvidovre, Denmark. Ingrid Poulsen, PhD RN, is Associate Professor and Research Manager, RUBRIC (Research Unit on Brain Injury Rehabilitation), Department of Neurorehabilitation, Traumatic Brain Injury, Rigshospitalet, Copenhagen University Hospital, Hvidovre; and Section of Nursing Science, Aarhus University, Aarhus, Denmark.

Copyright

(Copyright © 2018, American Association of Neuroscience Nurses)

DOI

10.1097/JNN.0000000000000365

PMID

29652735

Abstract

BACKGROUND: Complications such as infections and conditions after immobilization are frequent after severe traumatic brain injury (TBI) due to compromised bodily functions. Traditionally, bodily functions are core elements in nursing, and therefore nurses in the rehabilitation departments are pivotal in the prevention of complications. Hence, the frequency of complications is an indicator of nursing care quality, which can be included in nursing-sensitive outcome indicators. To do so, it is necessary to know the frequency of the selected complications.

OBJECTIVE: The aim of this study was to quantify complications during the first year after severe TBI. PARTICIPANTS: This study included patients 15 years or older who received subacute neurorehabilitation after severe TBI from 2011 to 2015 (N = 469).

DESIGN: This is a register-based follow-up study using data from the Danish Head Trauma Database, a national clinical quality database aimed at monitoring and improving the quality of rehabilitation for patients with severe TBI. MAIN MEASURES: The following complications were assessed: urinary tract infection, pneumonia, pressure ulcers, joint contractures, and deep venous thrombosis. The prevalence of each complication was calculated at admission, discharge, and 1 year postinjury and for the period from admission and during subacute rehabilitation. In addition, the frequency of complications that certainly developed during subacute rehabilitation was calculated. Complications were compared between age-specific subgroups using multivariable binominal regression analyses.

RESULTS: Urinary tract infections (53%) and pneumonia (32%) were the most common complications in the period from admission and during subacute rehabilitation. Pressure ulcers (18%), joint contractures (18%), and deep venous thrombosis (4%) were less frequent. At discharge and 1 year postinjury, the prevalence was less than 4% for all complications, except for joint contractures (16% and 13% at discharge and 1 year postinjury, respectively).

CONCLUSION: The prevalence of complications was high. The findings are important for future quality improvement of the rehabilitation trajectory and for further studies that explore the high frequency of complications.

Language: en