Reduced mortality after severe head injury will increase the demands for rehabilitation sevices

Primary objective: In 1989, a new therapy to reduce intracranial pressure i n severely head-injured patients was introduced in Lund. The new treatment reduced mortality significantly. The present study describes the quality of life for the survivor; Methods and procedures: The study includes 53 patients treated during 1989- 1994, according to a new treatment protocol for increased intracranial pres sure ('Lund concept' group). During 1982-1986, 38 patients were managed acc ording to a protocol including high dose thiopentone ('Thiopentone' group). The two groups are compared regarding neurophysical and psychiatric sympto ms as well as aspects regarding the patient's role, performance, interperso nal relationship, frictions, feelings and satisfaction in work, areas of so cial and leisure activities, and extended family. Results: Mortality was reduced from 47% to 8%, but the number of patients w ith a persistent vegetative state and/or remaining severe disability did no t increase. However, the number of patients with persisting emotional and i ntellectual deficits increased significantly. Conclusion: The new treatment regime has dramatically increased the number of survivors after severe head trauma. Although most patients have a favour able outcome, there are more patients with remaining sequelae and disabilit ies, and the demand for qualified rehabilitation has increased.