Affiliations: [a] Unità di Riabilitazione Neuromotoria Gravi Cerebrolesioni Acquisite, Istituti Clinici Scientifici Maugeri Spa Società Benefit, IRCCS Montescano, Pavia, Italy
| [b] Dipartimento di Biologia e Biotecnologie “Lazzaro Spallanzani” Università degli Studi di Pavia, Pavia, Italy
| [c] Dipartimento di Ingegneria Biomedica, Istituti Clinici Scientifici Maugeri Spa Società Benefit, IRCCS Montescano, Pavia, Italy
| [d] Divisione di Riabilitazione Cardiaca, Istituti Clinici Scientifici Maugeri, IRCCS Lumezzane, Brescia, Italy
| [e] Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
Correspondence:
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Address for correspondence: Manuela Verri, PhD, Dipartimento di Biologia e Biotecnologie “Lazzaro Spallanzani”, Università degli Studi di Pavia, Via Ferrata 9, 27100 Pavia, Italy. Tel.: +39 0382 986423; Fax: +39 0382 986385; E-mail: [email protected].
Note: [1] M. Boselli and R. Aquilani contributed equally to this work.
Abstract: BACKGROUND:Systemic inflammation and its impact on rehabilitation for patients with non-traumatic haemorrhagic injury (HBI) sequelae has not yet been adequately documented. OBJECTIVE AND METHODS:We therefore considered 31 patients with HBI, to determine the serum levels of inflammatory markers (C-Reactive Protein, CRP and or interleukine-6, IL-6) to establish their impact on functional status (Functional Independence Measure, FIM: 18 indicating the worst performance and 126, a normal score). RESULTS:The results showed an inflammation prevalence (CRP >0.5 mg/dl and/or IL 6 >7 pg/ml) of 74.2% at admission to Rehab. FIM reduction was more pronounced in inflamed compared to non-inflamed subjects (p < 0.05) and significantly correlated with blood variables sensitive to inflammation, such as alpha 1 globulin (r = – 0.565) and neutrophil/ lymphocyte ratio (r = – 0.52), CRP (r = – 0.365). At discharge from Rehab, the inflammation rate diminished. Inflamed patients showed similar gains in FIM score as their controls. In the entire population, the FIM gain was significantly associated with a gain in serum albumin, only (r = +0.56). CONCLUSIONS:We conclude that systemic inflammation is prevalent in HBI patients and contributes to reduce patient functional status. However, during the Rehab stage, inflammation does not hinder the improvement rate of functional capacity.
