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

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.