@article{3032248,
    title = "Risk factors for 2-year mortality in patients with prolonged disorders
of consciousness: An international multicentre study",
    author = "Estraneo, Anna and Magliacano, Alfonso and Fiorenza, Salvatore and and Formisano, Rita and Grippo, Antonello and Angelakis, Efthymios and and Cassol, Helena and Thibaut, Aurore and Gosseries, Olivia and Lamberti, and Gianfranco and Noe, Enrique and Bagnato, Sergio and Edlow, Brian L. and and Chatelle, Camille and Lejeune, Nicolas and Veeramuthu, Vigneswaran and and Bartolo, Michelangelo and Mattia, Donatella and Toppi, Jlenia and and Zasler, Nathan and Schnakers, Caroline and Trojano, Luigi",
    journal = "European Journal of Paediatric Neurology",
    year = "2022",
    volume = "29",
    number = "2",
    pages = "390-399",
    publisher = "Wiley",
    issn = "1090-3798",
    doi = "10.1111/ene.15143",
    keywords = "disorders of consciousness; minimally conscious state; mortality;
prognosis; vegetative state",
    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 < 0.001).
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. Conclusions This study demonstrated that a
feasible multimodal assessment in the postacute 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."
}