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.

Estraneo, A., Masotta, O., Bartolo, M., Pistoia, F., Perin, C., Marino, S., et al. (2021). Multi-center study on overall clinical complexity of patients with prolonged disorders of consciousness of different etiologies. BRAIN INJURY, 35(1), 1-7 [10.1080/02699052.2020.1861652].

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

Perin C.;
2021

Abstract

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.
Articolo in rivista - Articolo scientifico
clinical complexity; Disorders of consciousness; medical complications; neurorehabilitation; outcome;
English
17-dic-2020
2021
35
1
1
7
none
Estraneo, A., Masotta, O., Bartolo, M., Pistoia, F., Perin, C., Marino, S., et al. (2021). Multi-center study on overall clinical complexity of patients with prolonged disorders of consciousness of different etiologies. BRAIN INJURY, 35(1), 1-7 [10.1080/02699052.2020.1861652].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/298458
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