Factors influencing recovery in a pediatric sample with disorders of consciousness: insights from an observational study.

IF 1.5 4区医学 Q4 NEUROSCIENCES

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-07-05 DOI:10.1080/02699052.2024.2372451

María Cecilia González, F Leguizamón, L Dei Vecchi, M Andreu, M Ferrea

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引用次数: 0

Abstract

Objective: To estimate rates and time to reach emergence of consciousness from vegetative state/unresponsive wakefulness syndrome (VS/UWS), and explore factors associated with improved recovery in children and adolescents with disorders of consciousness (DoC) following severe traumatic and non-traumatic brain injury.

Methods: Analytical, retrospective, cohort study. Clinical records of consecutively referred patients admitted in VS/UWS to a neurological rehabilitation institute in Argentina, between 2005 and 2021 were reviewed. Seventy children and adolescents were included in the analysis. A specialized 12-week rehabilitation program was administered, and emergence was defined by scores ≥44 points on the Western Neuro Sensory Stimulation Profile (WNSSP), sustained for at least 3 weeks on consecutive weekly evaluations.

Results: Emergence from VS/UWS to consciousness occurred within 5.4 (SD 2.6) weeks in almost one-third of patients. Multivariate Cox regression analysis showed emergence was significantly lower in patients with hypoxic ischemic encephalopathy compared to patients with other non-traumatic etiologies [HRadj 0.23 (95% CI 0.06-0.89); p = 0.03)].

Conclusions: Our findings reinforce growing evidence on the impact of etiology on DoC recovery in pediatric populations, ultimately influencing treatment and family-related decisions in child neurorehabilitation.

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影响意识障碍儿科样本康复的因素：一项观察性研究的启示。

目的估算从植物状态/无反应清醒综合征（VS/UWS）中恢复意识的比率和时间，并探讨严重创伤性和非创伤性脑损伤后出现意识障碍（DoC）的儿童和青少年恢复情况改善的相关因素：分析、回顾性队列研究。研究回顾了 2005 年至 2021 年期间阿根廷一家神经康复机构连续转诊的 VS/UWS 患者的临床记录。70名儿童和青少年被纳入分析范围。患者接受了为期12周的专业康复治疗，在西方神经感觉刺激量表（WNSSP）上得分≥44分，并在连续的每周评估中至少持续3周，即为痊愈：近三分之一的患者在 5.4 周（标准差 2.6 周）内从 VS/UWS 恢复意识。多变量 Cox 回归分析显示，与其他非创伤性病因的患者相比，缺氧缺血性脑病患者的意识恢复时间明显更短[HRadj 0.23 (95% CI 0.06-0.89); p = 0.03)]：我们的研究结果进一步证实了病因对儿童DoC恢复的影响，并最终影响了儿童神经康复治疗和家庭相关决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain injury 医学-康复医学

CiteScore

3.50

自引率

5.30%

发文量

148

审稿时长

12 months

期刊介绍： Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.