@article{ref1,
title="Risk factors for two-year mortality in patients with prolonged disorders of consciousness: an international multicenter study",
journal="European journal of neurology",
year="2021",
author="Estraneo, Anna and Magliacano, Alfonso and Fiorenza, Salvatore and Formisano, Rita and Grippo, Antonello and Angelakis, Efthymios and Cassol, Helena and Thibaut, Aurore and Gosseries, Olivia and Lamberti, Gianfranco and Noé, Enrique and Bagnato, Sergio and Edlow, Brian L. and Chatelle, Camille and Lejeune, Nicolas and Veeramuthu, Vigneswaran and Bartolo, Michelangelo and Mattia, Donatella and Toppi, Jlenia and Zasler, Nathan and Schnakers, Caroline and Trojano, Luigi",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Patients with prolonged disorders of consciousness (pDoC) have a high mortality rate due to medical complications. Since an accurate prognosis is essential for decision-making on patients' management, we analysed data from an international multicentre prospective cohort study to evaluate two-year mortality rate and bedside predictors of mortality. <br><br>METHODS: We enrolled adult patients in prolonged vegetative state/unresponsive wakefulness syndrome (VS/UWS) or minimally conscious state (MCS) after traumatic and non-traumatic brain injury within 3 months post-injury. At enrolment we collected demographic (age; sex), anamnestic (etiology; time post-injury), clinical (Coma Recovery Scale Revised, CRS-R; Disability Rating Scale; Nociception Coma Scale-Revised) and neurophysiologic (EEG; somatosensory evoked and event-related potentials) data. Patients were followed-up to gather data on mortality up to 24 months post- injury. <br><br>RESULTS: Among 143 traumatic (n=55) and non-traumatic (n=88) patients (VS/UWS=68, 19 females; MCS=75, 22 females), 41 (28.7%) died within 24 months post-injury. Mortality rate was higher in VS/UWS (42.6%) than in MCS (16%; p<.001). Multivariate regression in VS/UWS showed that significant predictors of mortality were older age and lower CRS-R total score, whereas in MCS female sex and absence of alpha rhythm on EEG at study entry were significant predictors. <br><br>CONCLUSIONS: This study demonstrated that a feasible multimodal assessment in the post-acute phase can help clinicians to identify patients with pDoC at higher risk of mortality within 24 months after brain injury. This evidence can help clinicians and patients' families to navigate the complex clinical decision-making process and promote an international standardization of prognostic procedures for patients with pDoC.<p /> <p>Language: en</p>",
language="en",
issn="1351-5101",
doi="10.1111/ene.15143",
url="http://dx.doi.org/10.1111/ene.15143"
}