HoNOS–ABI: a reliable outcome measure of neuropsychiatric sequelae to brain injury?

Aims and Method

The Health of the Nation Outcome Scale for Acquired Brain Injury (HoNOS–ABI) is a relatively new outcome measure designed to assess the neuropsychiatric sequelae of brain damage. This study investigated the interrater reliability of this scale. Fifty patients with traumatic brain injury receiving rehabilitation were each rated twice on the HoNOS–ABI, by two different raters. There were 24 raters in total.

Results

Weighted kappa values ranged from 0.43 to 0.84 and intraclass correlation coefficients from 0.58 to 0.97 for the ten items assessed. This indicated that agreement was moderate to substantial for all items.

Clinical Implications

The scales consistently measured the items of interest across different raters. This indicates that HoNOS–ABI is a reliable outcome measure when applied by different raters in routine clinical practice.

Laparoscopic Transplantation Following Transvaginal Insertion of the Kidney: Description of Technique and Outcome

Laparoscopic kidney transplantation (LKT) is well accepted modality of treatment for ESRD patients at our center. Usually, the kidney is inserted through small Pfannenstiel incision. With the permission of the Internal Review Board, we carried out LKT in eight female recipients following insertion of the kidney through the vagina. The kidney was procured by the retroperitoneoscopic approach. Antibiotic prophylaxis was given. All cases were carried out successfully with immediate graft function and 100% graft and patient survival at 1 year of follow-up. Estimated glomerular filtration rate at 1 month and 1 year was similar to eight randomly selected female recipients who underwent open kidney transplantation (OKT). No analgesia was required in seven out of eight patients after the 3rd postoperative day. In summary, vaginal insertion of kidney and LKT is safe and feasible in a selected group of patients. It is associated with better analgesia and has similar allograft function as compare to OKT.