{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:11Z","timestamp":1788419771248,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe acquired brain injury (sABI) is a major cause of mortality and long-term disability. Although its prevalence is increasing among older adults (\u226565 years), evidence on independent determinant of rehabilitation outcomes in this population remains limited. This study aimed to identify early factors associated with poor functional outcomes and mortality in younger and older patients undergoing intensive inpatient rehabilitation following severe acquired brain injury (sABI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center, retrospective cohort study, 215 patients (91 aged \u226565; 124 aged &amp;lt;65) admitted to a tertiary neurorehabilitation unit were enrolled. Demographic characteristics, sABI etiology, comorbidities, dysphagia, and multidrug-resistant organism (MDRO) colonization at admission, as well as the occurrence of sepsis, hospital-acquired pneumonia (HAP), and in-hospital mortality, were evaluated. Multivariable linear regression models were used to identify factors independently associated with poorer outcomes in terms of Glasgow Coma Scale (GCS), Functional Independence Measure (FIM), and Glasgow Outcome Scale\u2013Extended (GOS-E) scores recorded at discharge from the unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among older patients, dysphagia (FIM\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001; GOS-E\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) and diabetes mellitus (FIM\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) were associated with poorer functional outcomes after sABI. In addition, MDRO colonization at admission (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016) and sepsis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) were associated with worse neurological status at discharge. In younger patients, dysphagia (FIM\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001; GOS-E\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and MDRO colonization (FIM\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) were associated with poorer functional outcomes, whereas MDRO colonization at admission (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) and HAP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016) were associated with worse neurological status at discharge. Despite comparable functional outcomes at discharge, older patients had significantly longer LOS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) and higher in-hospital mortality (34 vs. 12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001). HAP was the factor most strongly associated with mortality in the overall cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dysphagia and pre-existing comorbidities, particularly diabetes mellitus, were associated with poorer rehabilitation outcomes in older patients with sABI. The association of MDRO colonization, HAP, and sepsis with poor outcomes across both age groups underscores the importance of early identification of high-risk patients and targeted preventive strategies to reduce modifiable complications, length of stay, and mortality during intensive rehabilitation after sABI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2026.1901401","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:44:30Z","timestamp":1788417870000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional recovery and mortality after intensive inpatient rehabilitation for severe acquired brain injury in older adults: a retrospective cohort study"],"prefix":"10.3389","volume":"7","author":[{"given":"Valeria","family":"Pingue","sequence":"first","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia","place":["Pavia, Italy"]},{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Units and Centro Studi Attivit\u00e0 Motorie (CSAM) of Pavia Institute","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Pavese","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia","place":["Pavia, Italy"]},{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Units and Centro Studi Attivit\u00e0 Motorie (CSAM) of Pavia Institute","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine Invernizzi","family":"Descalzi","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Units and Centro Studi Attivit\u00e0 Motorie (CSAM) of Pavia Institute","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loretta","family":"Fiorina","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Microbiology and Virology Unit, Istituti Clinici Scientifici Maugeri IRCCS","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Gabba","sequence":"additional","affiliation":[{"name":"Occupational Therapy and Ergonomics Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Bellaviti","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Units and Centro Studi Attivit\u00e0 Motorie (CSAM) of Pavia Institute","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Nardone","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia","place":["Pavia, Italy"]},{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Units and Centro Studi Attivit\u00e0 Motorie (CSAM) of Pavia Institute","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1001\/jamaneurol.2022.5024","article-title":"Head injury and long-term mortality risk in community-dwelling adults","volume":"80","author":"Elser","year":"2023","journal-title":"JAMA Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1663431","DOI":"10.3389\/fneur.2026.1663431","article-title":"Impact of hospital-acquired pneumonia on rehabilitation outcomes and mortality in patients after severe acquired brain injury: a retrospective cohort study","volume":"17","author":"Pingue","year":"2026","journal-title":"Front Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1186\/s12877-022-03651-x","article-title":"Factors associated with an unfavourable outcome in elderly intensive care traumatic brain injury patients: a retrospective multicentre study","volume":"22","author":"Launey","year":"2022","journal-title":"BMC Geriatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1164\/rccm.201903-0673OC","article-title":"Long-Term outcomes after severe traumatic brain injury in older adults. 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