Risk factors for 2-year mortality in patients with prolonged disorders of consciousness: An international multicentre study

Estraneo A 1 , Magliacano A 1 , Fiorenza S 2 , Formisano R 3 , Grippo A 1 , Angelakis E 4 Show all authors , Cassol H 5 , Thibaut A 5 , Gosseries O 5 , Lamberti G 6 , Noé E 7 , Bagnato S 8 , Edlow BL 9 , Chatelle C 9 , Lejeune N 10 , Veeramuthu V 11 , Bartolo M 12 , Mattia D 3 , Toppi J 13 , Zasler N 14 , Schnakers C 15 , Trojano L 16

Affiliations 

  • 1 Don Carlo Gnocchi Foundation, Scientific Institute for Research and Health Care, Florence, Italy
  • 2 Maugeri Clinical Scientific Institutes, Scientific Institute for Research and Health Care, Laboratory for the Multimodal Evaluation of Disorders of Consciousness, Telese Terme, Italy
  • 3 Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
  • 4 Neurosurgery Department, University of Athens Medical School, Athens, Greece
  • 5 Coma Science Group, GIGA Consciousness, University and University Hospital of Liège, Liège, Belgium
  • 6 Neurorehabilitation and Vegetative State Unit E. Viglietta, Cuneo, Italy
  • 7 NEURORHB-Neurorehabilitation Service of Vithas Hospitals, Valencia, Spain
  • 8 Unit of Neurophysiology and Unit for Severe Acquired Brain Injuries, Rehabilitation Department, Giuseppe Giglio Foundation, Cefalù, Italy
  • 9 Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
  • 10 Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium
  • 11 Department of Psychology, University of Reading Malaysia, Iskandar Puteri, Malaysia
  • 12 Neurorehabilitation Unit, HABILITA Zingonia/Ciserano, Bergamo, Italy
  • 13 Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
  • 14 Concussion Care Centre of Virginia, Richmond, Virginia, USA
  • 15 Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
  • 16 Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
Eur J Neurol, 2022 Feb;29(2):390-399.
PMID: 34657359 DOI: 10.1111/ene.15143

Abstract

BACKGROUND AND PURPOSE: Patients with prolonged disorders of consciousness (pDoC) have a high mortality rate due to medical complications. Because an accurate prognosis is essential for decision-making on patients' management, we analysed data from an international multicentre prospective cohort study to evaluate 2-year mortality rate and bedside predictors of mortality.

METHODS: We enrolled adult patients in prolonged vegetative state/unresponsive wakefulness syndrome (VS/UWS) or minimally conscious state (MCS) after traumatic and nontraumatic brain injury within 3 months postinjury. At enrolment, we collected demographic (age, sex), anamnestic (aetiology, time postinjury), clinical (Coma Recovery Scale-Revised [CRS-R], Disability Rating Scale, Nociception Coma Scale-Revised), and neurophysiologic (electroencephalogram [EEG], somatosensory evoked and event-related potentials) data. Patients were followed up to gather data on mortality up to 24 months postinjury.

RESULTS: Among 143 traumatic (n = 55) and nontraumatic (n = 88) patients (VS/UWS, n = 68, 19 females; MCS, n = 75, 22 females), 41 (28.7%) died within 24 months postinjury. Mortality rate was higher in VS/UWS (42.6%) than in MCS (16%; p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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