A longitudinal retrospective study on determinants of survival in chronic patients with severe acquired brain injuries and Disorders of Consciousness.

IF 1.8 4区医学 Q4 NEUROSCIENCES

Brain injury Pub Date : 2025-09-18 DOI:10.1080/02699052.2025.2558955

Camilla Ippoliti, Francesca Giulia Magnani, Arianna Fornari, Martina Cacciatore, Filippo Barbadoro, Cinzia Stellato, Matilde Leonardi

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Abstract

Objective: To explore the survival time of adult chronic patients with Disorders of Consciousness (DOC).

Methods: We retrospectively considered 244 chronic DOC patients in 14 long-term care (LTC) facilities from 2017 to 2020. We considered patients' demographics (age, sex) and clinical (etiology, Body Mass Index) variables to explore any difference in survival probabilities. For longitudinal descriptive purposes, time from acute events and total scores at different clinical scales addressing patients' level of consciousness and disability were also considered.

Results: At the end of the 3-year follow-up period, 136 patients out of 244 died. The median overall survival was 67.6 months from the acute event, with significantly longer survival for younger patients and patients with traumatic etiology. However, almost all traumatic patients fall into the youngest patients' group.

Conclusion: During LTC hospitalization, chronic DOC patients showed a high level of disability and their clinical profile remained stable unless comorbidities or clinical complications arose. Age at the acute event is the main factor explaining survival probability, while the role of etiology, an already-known relevant factor for prognosis in the acute and post-acute phases, might be secondary in the chronic phase.

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重度获得性脑损伤和意识障碍慢性患者生存决定因素的纵向回顾性研究。

目的：探讨成人慢性意识障碍（DOC）患者的生存时间。方法：我们回顾性分析了2017年至2020年14家长期护理（LTC）机构的244例慢性DOC患者。我们考虑了患者的人口统计学（年龄、性别）和临床（病因学、体重指数）变量，以探索生存概率的差异。为了纵向描述的目的，还考虑了急性事件的时间和不同临床量表的总分，以解决患者的意识和残疾水平。结果：3年随访期结束时，244例患者中有136例死亡。急性事件后的中位总生存期为67.6个月，年轻患者和创伤性病因患者的生存期明显更长。然而，几乎所有的创伤患者都属于最年轻的患者群体。结论：在LTC住院期间，慢性DOC患者表现出高水平的残疾，除非出现合并症或临床并发症，否则其临床状况保持稳定。急性发病时的年龄是解释生存率的主要因素，而病因学在急性期和急性期后是已知的影响预后的相关因素，在慢性期可能是次要的。

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.