Multi-center study on overall clinical complexity of patients with prolonged disorders of consciousness of different etiologies

Aim: to assess overall clinical complexity of patients with acquired disorders of consciousness (DoC) in vegetative state/unresponsive wakefulness syndrome (VS/UWS) vs. minimally conscious state- MCS) and in different etiologies.. Design: Multi-center cross-sectional observational study. Setting: 23...

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Vydané v:Brain injury Ročník 35; číslo 1; s. 1 - 7
Hlavní autori: Estraneo, A, Masotta, O, Bartolo, M, Pistoia, F, Perin, C, Marino, S, Lucca, L, Pingue, V, Casanova, E, Romoli, A, Gentile, S, Formisano, R, Salvi, GP, Scarponi, F, De Tanti, A, Bongioanni, P, Rossato, E, Santangelo, A, Diana, AR, Gambarin, M, Intiso, D, Antenucci, R, Premoselli, S, Bertoni, M, De Bellis, F
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Taylor & Francis 05.01.2021
Predmet:
clinical complexity
Disorders of consciousness
medical complications
neurorehabilitation
outcome
medical complications
clinical complexity
Disorders of consciousness
neurorehabilitation
outcome
ISSN:0269-9052, 1362-301X, 1362-301X
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Shrnutí:Aim: to assess overall clinical complexity of patients with acquired disorders of consciousness (DoC) in vegetative state/unresponsive wakefulness syndrome (VS/UWS) vs. minimally conscious state- MCS) and in different etiologies.. Design: Multi-center cross-sectional observational study. Setting: 23 intensive neurorehabilitation units. Subjects: 264 patients with DoC in the post-acute phase: VS/UWS = 141, and MCS = 123 due to vascular (n = 125), traumatic (n = 83) or anoxic (n = 56) brain injury. Main Measures: Coma Recovery Scale-Revised, and Disability Rating Scale (DRS); presence of medical devices (e.g., for eating or breathing); occurrence and severity of medical complications. Results: patients in DoC, and particularly those in VS/UWS, showed severe overall clinical complexity. Anoxic patients had higher overall clinical complexity, lower level of responsiveness/consciousness, higher functional disability, and higher needs of medical devices. Vascular patients had worse premorbid clinical comorbidities. The two etiologies showed a comparable rate of MC, higher than that observed in traumatic etiology. Conclusion: overall clinical complexity is significantly higher in VS/UWS than in MCS, and in non-traumatic vs. traumatic etiology. These findings could explain the worse clinical evolution reported in anoxic and vascular etiologies and in VS/UWS patients and contribute to plan patient-tailored care and rehabilitation programmes.
Bibliografia:ObjectType-Article-1
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ISSN:0269-9052
1362-301X
1362-301X
DOI:10.1080/02699052.2020.1861652