Outcome prediction in disorders of consciousness: the role of coma recovery scale revised
Abstract Background To evaluate the utility of the revised coma remission scale (CRS-r), together with other clinical variables, in predicting emergence from disorders of consciousness (DoC) during intensive rehabilitation care. Methods Data were retrospectively extracted from the medical records of...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Neurology |
| Online Access: | http://link.springer.com/article/10.1186/s12883-019-1293-7 |
| _version_ | 1811291692402212864 |
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| author | Lucia Francesca Lucca Danilo Lofaro Loris Pignolo Elio Leto Maria Ursino Maria Daniela Cortese Domenico Conforti Paolo Tonin Antonio Cerasa |
| author_facet | Lucia Francesca Lucca Danilo Lofaro Loris Pignolo Elio Leto Maria Ursino Maria Daniela Cortese Domenico Conforti Paolo Tonin Antonio Cerasa |
| author_sort | Lucia Francesca Lucca |
| collection | DOAJ |
| description | Abstract Background To evaluate the utility of the revised coma remission scale (CRS-r), together with other clinical variables, in predicting emergence from disorders of consciousness (DoC) during intensive rehabilitation care. Methods Data were retrospectively extracted from the medical records of patients enrolled in a specialized intensive rehabilitation unit. 123 patients in a vegetative state (VS) and 57 in a minimally conscious state (MCS) were included and followed for a period of 8 weeks. Demographical and clinical factors were used as outcome measures. Univariate and multivariate Cox regression models were employed for examining potential predictors for clinical outcome along the time. Results VS and MCS groups were matched for demographical and clinical variables (i.e., age, aetiology, tracheostomy and route of feeding). Within 2 months after admission in intensive neurorehabilitation unit, 3.9% were dead, 35.5% had a full recovery of consciousness and 66.7% remained in VS or MCS. Multivariate analysis demonstrated that the best predictor of functional improvement was the CRS-r scores. In particular, patients with values greater than 12 at admission were those with a favourable likelihood of emergence from DoC. Conclusions Our study highlights the role of the CRS-r scores for predicting a short-term favorable outcome. |
| first_indexed | 2024-04-13T04:34:14Z |
| format | Article |
| id | doaj.art-6907b27892a14e94bcbd4d9b67a3711f |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-04-13T04:34:14Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-6907b27892a14e94bcbd4d9b67a3711f2022-12-22T03:02:14ZengBMCBMC Neurology1471-23772019-04-011911810.1186/s12883-019-1293-7Outcome prediction in disorders of consciousness: the role of coma recovery scale revisedLucia Francesca Lucca0Danilo Lofaro1Loris Pignolo2Elio Leto3Maria Ursino4Maria Daniela Cortese5Domenico Conforti6Paolo Tonin7Antonio Cerasa8S. Anna Institute and Research in Advanced Neurorehabilitation (RAN)Dipartimento di Ingegneria Meccanica, Energetica e Gestionale – DIMEG, UNICAL, Arcavata di Rende (CS)S. Anna Institute and Research in Advanced Neurorehabilitation (RAN)S. Anna Institute and Research in Advanced Neurorehabilitation (RAN)S. Anna Institute and Research in Advanced Neurorehabilitation (RAN)S. Anna Institute and Research in Advanced Neurorehabilitation (RAN)Kidney and Transplantation Research Center, Annunziata HospitalS. Anna Institute and Research in Advanced Neurorehabilitation (RAN)S. Anna Institute and Research in Advanced Neurorehabilitation (RAN)Abstract Background To evaluate the utility of the revised coma remission scale (CRS-r), together with other clinical variables, in predicting emergence from disorders of consciousness (DoC) during intensive rehabilitation care. Methods Data were retrospectively extracted from the medical records of patients enrolled in a specialized intensive rehabilitation unit. 123 patients in a vegetative state (VS) and 57 in a minimally conscious state (MCS) were included and followed for a period of 8 weeks. Demographical and clinical factors were used as outcome measures. Univariate and multivariate Cox regression models were employed for examining potential predictors for clinical outcome along the time. Results VS and MCS groups were matched for demographical and clinical variables (i.e., age, aetiology, tracheostomy and route of feeding). Within 2 months after admission in intensive neurorehabilitation unit, 3.9% were dead, 35.5% had a full recovery of consciousness and 66.7% remained in VS or MCS. Multivariate analysis demonstrated that the best predictor of functional improvement was the CRS-r scores. In particular, patients with values greater than 12 at admission were those with a favourable likelihood of emergence from DoC. Conclusions Our study highlights the role of the CRS-r scores for predicting a short-term favorable outcome.http://link.springer.com/article/10.1186/s12883-019-1293-7 |
| spellingShingle | Lucia Francesca Lucca Danilo Lofaro Loris Pignolo Elio Leto Maria Ursino Maria Daniela Cortese Domenico Conforti Paolo Tonin Antonio Cerasa Outcome prediction in disorders of consciousness: the role of coma recovery scale revised BMC Neurology |
| title | Outcome prediction in disorders of consciousness: the role of coma recovery scale revised |
| title_full | Outcome prediction in disorders of consciousness: the role of coma recovery scale revised |
| title_fullStr | Outcome prediction in disorders of consciousness: the role of coma recovery scale revised |
| title_full_unstemmed | Outcome prediction in disorders of consciousness: the role of coma recovery scale revised |
| title_short | Outcome prediction in disorders of consciousness: the role of coma recovery scale revised |
| title_sort | outcome prediction in disorders of consciousness the role of coma recovery scale revised |
| url | http://link.springer.com/article/10.1186/s12883-019-1293-7 |
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