Consciousness recovery after various periods in vegetative state

Abstract

The odds of consciousness recovery are considered to be poor after several months in vegetative state (VS). The rate of recovery from VS, however, improved in the last 20 years. The present study examined the odds of consciousness recovery after various periods in VS. Recovery from VS was monitored during several periods after admission to intensive care and consciousness rehabilitation (ICCR) in 206 patients in VS lasting more than 1 month. Recovery from VS was established when the ICCR physician and the multidisciplinary team observed that patients who previously were not able to create functional communication or use objects, established communication with the environment by obeying simple commands, but not complex commands that patients with locked-in syndrome can obey. Recovery of consciousness was recorded in 111 patients, of whom 24, 40, 24, 16, and 7 were discharged from ICCR within 3, 3–6, 6–9, 9–12, and 12–19 months, respectively. Additional patients, lost to follow-up, may have recovered consciousness after discharge from ICCR. The odds of recovery from VS was, therefore, at least 54% at admission to ICCR, 48% after 3 months, 33% after 6 months, 19% after 9 months, and 7% 12 months after admission (approximately 2, 5, 8, 11, and 14 months after injury or lesion onset). The difference in the odds of recovery from VS between the examined periods were significant ( P < 0.001). The odds of recovery from VS decrease significantly with time, but are not negligible even more than 6 months after admission to ICCR, and more than 8 months after injury. Future study of functional outcomes after VS recovery may help determine the optimal duration of the period from injury to ICCR, and the optimal length of stay in ICCR.