Multi-center observational study on occurrence and related clinical factors of neurogenic heterotopic ossification in patients with disorders of consciousness

Aims: to assess occurrence and clinical correlates of neurogenic heterotopic ossifications (NHO) in patients with prolonged disorder of consciousness (DoC). Design: multi-center cross-sectional observational study. Setting: 23 intensive neurorehabilitation units. Subjects: 287 patients with prolonge...

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Vydáno v:	Brain injury Ročník 35; číslo 5; s. 530 - 535
Hlavní autoři:	Estraneo, A, Pascarella, A, Masotta, O, Bartolo, M, Pistoia, F, Perin, C, Marino, S, Lucca, L, Pingue, V, Casanova, E, Romoli, AM, 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, Trojano, L
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England Taylor & Francis 16.04.2021
Témata:	disorders of consciousness Heterotopic ossification minimally conscious state rehabilitation vegetative state disorders of consciousness rehabilitation Heterotopic ossification minimally conscious state vegetative state
ISSN:	0269-9052, 1362-301X, 1362-301X
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Shrnutí:	Aims: to assess occurrence and clinical correlates of neurogenic heterotopic ossifications (NHO) in patients with prolonged disorder of consciousness (DoC). Design: multi-center cross-sectional observational study. Setting: 23 intensive neurorehabilitation units. Subjects: 287 patients with prolonged disorder of consciousness (DoC; 150 in vegetative state, VS, and 128 in minimally conscious state, MCS) of different etiology (vascular = 125, traumatic = 83, anoxic = 56, others = 14). Main Measures: clinical evidence of NHO confirmed by standard radiological and/or sonographic evaluation; Coma Recovery Scale-Revised; Disability Rating Scale (DRS); Early Rehabilitation Barthel Index; presence of ventilator support, spasticity, bone fractures and paroxysmal sympathetic hyperactivity. Results: 31 patients (11.2%) presented NHO. Univariate analyses showed that NHO was associated with VS diagnosis, traumatic etiology, high DRS category and total score, and high occurrence of limb spasticity and bone fractures. A cluster-corrected binary logistic regression model (excluding spasticity available in a subset of patients) showed that only lower DRS total score and presence of bone fractures were independently associated with NHO. Conclusions: NHO are relatively frequent in patients with DoC, and are independently associated with functional disability, bone fractures and spasticity. These findings contribute to identifying patients with DoC prone to develop NHO and requiring special interventions to improve functional recovery.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0269-9052 1362-301X 1362-301X
DOI:	10.1080/02699052.2021.1893384