期刊
JOURNAL OF NEUROTRAUMA
卷 37, 期 2, 页码 357-365出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/neu.2019.6429
关键词
consciousness; MCS; outcome research; TBI; VS
资金
- National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR)
- National Institute on Disability and Rehabilitation Research (NIDRR), United States Department of Education [H133A031713]
- National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living [90DP0039, 90DP0036, 90DP0028]
- Department of Defense [W81XWH-14-2-0176]
- NIH [1U01NS086090, N5065980]
- serves on the board of the Brain Injury Association of Pennsylvania
- 2015 Council on Brain Injury (COBI) award
- NIDILRR [90DP0028, 90RT5007, 90DP0060]
- National Heart, Lung, and Blood Institute (NHLBI) [5U01HL088942-08]
- NINDS [1R03NS079875-01A1, 6R37NS043209-14]
- NIGMS [R25GM111239-01A1]
- NHGRI [3U01HG007278-03S1]
- NIDDK [1R01DK102420-01A1]
- NCI [1R01CA163772-01A1]
- James S. McDonnell Foundation
The extent of behavioral recovery that occurs in patients with traumatic disorders of consciousness (DoC) following discharge from the acute care setting has been under-studied and increases the risk of overly pessimistic outcome prediction. The aim of this observational cohort study was to systematically track behavioral and functional recovery in patients with prolonged traumatic DoC following discharge from the acute care setting. Standardized behavioral data were acquired from 95 patients in a minimally conscious (MCS) or vegetative state (VS) recruited from 11 clinic sites and randomly assigned to the placebo arm of a previously completed prospective clinical trial. Patients were followed for 6 weeks by blinded observers to determine frequency of recovery of six target behaviors associated with functional status. The Coma Recovery Scale-Revised and Disability Rating Scale were used to track reemergence of target behaviors and assess degree of functional disability, respectively. Twenty percent (95% confidence interval [CI]: 13-30%) of participants (mean age 37.2; median 47 days post-injury; 69 men) recovered all six target behaviors within the 6 week observation period. The odds of recovering a specific target behavior were 3.2 (95% CI: 1.2-8.1) to 7.8 (95% CI: 2.7-23.0) times higher for patients in MCS than for those in VS. Patients with preserved language function (MCS+) recovered the most behaviors (p <= 0.002) and had the least disability (p <= 0.002) at follow-up. These findings suggest that recovery of high-level behaviors underpinning functional independence is common in patients with prolonged traumatic DoC. Clinicians involved in early prognostic counseling should recognize that failure to emerge from traumatic DoC before 28 days does not necessarily portend unfavorable outcome.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据