Are rehabilitation outcomes after severe anoxic brain injury different from severe traumatic brain injury? A matched case–control study Emre Adıgüzel a , Evren Yaşar b , Serdar Kesikburun b , Yasin Demir a , Berke Aras d , Ismail Safaz b ,Rıdvan Alaca c and Arif K. Tan b Many reports have investigated rehabilitation outcomes after a traumatic brain injury (TBI); however, comparably less is known about whether they differ from outcomes of an anoxic brain injury (ABI). Thus, we aimed to compare the rehabilitation outcomes of patients with ABI with control patients who have TBI. Forty participants with ABI and 40 participants with TBI were included in this retrospective study. Participants with ABI were matched with participants with TBI who had similar clinical characteristics such as age, initial Functional Independence Measurement (FIM) score, and duration of coma. FIM and Functional Ambulation Classification (FAC) scores on rehabilitation admission and on rehabilitation discharge were recorded. The FIM score in the ABI group was 41.7 ± 28.5 on rehabilitation admission and increased to 57.1 ± 31.4 on rehabilitation discharge. The FIM score in the TBI group was 40.8 ± 24.0 on rehabilitation admission and increased to 65.9 ± 35.3 on rehabilitation discharge. There was no statistically significant difference in the FIM scores on rehabilitation discharge between groups. Initial FAC was similar in both groups and there was no statistically significant difference in the FAC scores on rehabilitation discharge. The multiple linear regression analysis showed that intensive care unit length of stay had an inverse relationship with the FAC change. We did not find significant differences in the rehabilitation outcomes of participants with ABI compared with participants with TBI. Considering the lack of information in the literature on ABI rehabilitation, this study may be important to guide rehabilitation teams. International Journal of Rehabilitation Research 00:000–000 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. International Journal of Rehabilitation Research 2017, 00:000–000 Keywords: anoxic–ischemic encephalopathy, hypoxic–ischemic encephalopathy, rehabilitation outcome a Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, b Department of Physical Medicine and Rehabilitation, Gülhane Medical School, Health Sciences University, c Department of Physical Medicine and Rehabilitation, Medicana Hospital, Ankara and d Kastamonu Physical Medicine and Rehabilitation Hospital, Kastamonu, Turkey Correspondence to Emre Adıgüzel, Üniversiteler Mah. Gaziler FTR EA Hastanesi, Bilkent, Ankara 06530, Turkey Tel: + 90 312 291 1118; fax: + 90 312 291 1009; e-mail: dremreadiguzel@gmail.com Received 15 May 2017 Accepted 21 September 2017 Introduction Anoxic brain injury (ABI), also called hypoxic–ischemic encephalopathy, is defined as inadequate oxygen supply of the brain because of an interruption or a decrease in the neural tissues’ vascular supply, which results in impairment in brain function (Parkin et al., 1987). Depending on the severity and duration of anoxia, the clinical presentation of the disease may differ (Caine and Watson, 2000; Gualtieri, 2002; Khot and Tirschwell, 2006). ABI may be caused by a cardiac or respiratory arrest, hanging, strangulation, poisoning with carbon monoxide, near-drowning, and anaphylaxis (Lishman, 1998; Gualtieri, 2002). Despite the wide range of causes, the improvements in resuscitation and prehospital emergency care have led to a significant increase in sur- vival rates after anoxic events (Bachman and Katz, 1997; Khot and Tirschwell, 2006). Thus, the number of ABI cases is increasing. The pathophysiology of ABI shows some differences from traumatic brain injury (TBI). In ABI, the gray matter is the main affected cortical structure because it is more vulnerable to ischemic injury than the white matter. The upper brainstem, cerebellum, and subcortical structures are supplied by the distal branches of deep and superficial penetrating blood vessels and these parts of the brain are mostly affected in the central nervous system (Arbelaez et al., 1999; Chalela et al., 2001; Busl and Greer, 2010). In addition, imaging studies in ABI reported a loss of gray–white junction, abnormal appearance of the deep gray matter nuclei, border-zone infarction, and laminar necrosis (Arbelaez et al., 1999). Nonetheless, in TBI, each patient has different clinical patterns according to the severity and the location of the injury. Many reports have investigated rehabilitation outcomes after a TBI; however, comparably less is known about whether they differ from the outcomes of an ABI. In addition, the lack of consistency between the existing studies does not allow a prediction of which patient will benefit from rehabilitation treatment. Although a few studies have reported poor outcomes after rehabilitation of ABI (Frankel et al., 2006; Cullen et al., 2009), others Original article 1 0342-5282 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MRR.0000000000000261 Copyright r 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.