Prevalence of persistent vegetative state in patients with severe traumatic brain injury and its trend during the past four decades: A meta-analysis

Tang, Qilin; Jin, Lei; Gao, Guoyi; Feng, Junfeng; Mao, Qing; Jiang, Jiyao

doi:10.3233/nre-161387

Cited by 11 publications

(8 citation statements)

References 43 publications

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“…Recent large-scale observational studies reported that 42% of patients admitted to the intensive care unit (ICU) with TBI in China and 37% in Europe had a GCS ≤ 8 [ 1 , 3 ]. An estimated 0.63–7.33% of patients presenting in coma following severe TBI are in a vegetative state 6 months after injury, and the incidence various significantly between centres [ 4 , 5 ]. Failure to emerge from coma, or emergence into a disorder of consciousness, presents important management and ethical problems, raising questions about the appropriateness of continued clinical care, and sometimes triggering decisions about withdrawal of life supporting treatments (WLST) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial

Wu,

Xie,

Lei

et al. 2023

Intensive Care Med

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Section: Introductionmentioning

confidence: 99%

Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial

Wu,

Xie,

Lei

et al. 2023

Intensive Care Med

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“…16 The data were used as a rough check on the validity of the estimated figures. Table 1 shows the five review papers found: the first published in 1994, 25 two published in 2014, 30,31 a systematic review restricted to head injury, 32 and a narrative review. 29 These reviews reveal how few primary studies there are, especially of incidence, and the low the quality of most studies.…”

Section: Finally I Have Collected Papers On People Withmentioning

confidence: 99%

“…Studies on populations of people with traumatic brain injury suggest an incidence of 0.29-0.7/100,000/year at four weeks from this cause and that between 3% and 7% of all incident cases of severe brain injury are in a PDOC at six months. 32,48…”

Section: Incidencementioning

confidence: 99%

How many patients in a prolonged disorder of consciousness might need a best interests meeting about starting or continuing gastrostomy feeding?

Wade

2018

Clin Rehabil

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Abstract. Objective:To estimate the number of people in a prolonged disorder of consciousness (PDOC) who may need a formal best interests decision-making process to consider starting and/or continuing life-sustaining treatment each year in the population of a developed country. Method:Identification of studies on people with a prolonged disorder of consciousness giving information about incidence, and/or prevalence, and/or cause ,and/or location of long-term care. Sources included systematic reviews, a new search of Medline (April 2018), and a personal collection of papers. Validating information was sought from existing data on services. Results:There are few epidemiologically sound studies, most having bias and/or missing information. The best estimate of incidence of PDOC due to acute-onset disease is 2.6/100,000/year; the best estimate of prevalence is between 2.0 and 5.0/100,000. There is evidence that prevalence in the Netherlands is about 10%of that in other countries. The commonest documented causes are cerebral hypoxia, stroke, traumatic brain injury, and tumours. There is some evidence suggesting that dementia is a common cause, but PDOC due to progressive disorders has not been studied systematically. Most people receive long-term in nursing homes, but a significant proportion (10%-15%) may be cared for at home.Conclusion: Each year about 5/100,000 people will enter a prolonged state of unconsciousness from acute onset and progressive brain damage; and at any one time there may be 5/100,000 people in that state. However, the evidence is very limited in quality and quantity. The numbers may be greater.

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“…The prevalence varies according to the location and time. There is no consensus of the relationship of the age and sex of the patients with PVS, and its epidemiology is still unclear for many countries [1,[7][8][9]. This may be related to the misdiagnosis rate in these patients which is not rare [10][11][12], and for this reason, it might compromise clinical statistics, medical practice, and therapy approach.…”

Section: Introductionmentioning

confidence: 99%

Persistent vegetative state: an overview

et al. 2021

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Background Disorder of consciousness diagnosis, especially when is classified as persistent vegetative state (without misestimating the other diagnosis classifications), in the intensive care is an important diagnosis to evaluate and treat. Persistent vegetative state diagnosis is a challenge in the daily clinical practice because the diagnosis is made mainly based upon the clinical history and the patient behavior observation. There are some specific criteria for this diagnosis, and this could be very tricky when the physician is not well trained. Main body We made a literature review regarding the persistent vegetative state diagnosis, clinical features, management, prognosis, and daily medical practice challenges while considering the bioethical issues and the family perspective about the patient status. The objective of this overview is to provide updated information regarding this clinical state’s features while considering the current medical literature available. Conclusions Regardless of the currently available guidelines and literature, there is still a lot of what we do not know about the persistent vegetative state. There is a lack of evidence regarding the optimal diagnosis and even more, about how to expect a natural history of this disorder of consciousness. It is important to recall that the patients (despite of their altered mental state diagnosis) should always be treated to avoid some of the intensive care unit long-stance complications.

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Prevalence of persistent vegetative state in patients with severe traumatic brain injury and its trend during the past four decades: A meta-analysis

Cited by 11 publications

References 43 publications

Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial

Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial

How many patients in a prolonged disorder of consciousness might need a best interests meeting about starting or continuing gastrostomy feeding?

Persistent vegetative state: an overview

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