Effects of comprehensive rehabilitation on complications and long-term prognoses of patients in vegetative and minimal consciousness states

X.-N. Zhang, Q.-Q. Chi, X. Zhang, Y. Zhang, X.-T. Sun, R.-R. Wang, H. Zhang

Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing Key Laboratory of Neural Injury and Rehabilitation, Capital Medical University School of Rehabilitation Medicine, Beijing, China. zh1665@163.com

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• Neurology

OBJECTIVE: To understand the clinical characteristics, prognoses, and prognostic factors of vegetative state (VS) and minimal consciousness state (MCS) patients hospitalized for comprehensive rehabilitation.
MATERIALS AND METHODS: The data of VS and MCS patients admitted in the past six years were retrospectively analyzed. Age of onset, etiology, course of disease, complications, and retention of tracheal intubation, gastric tube, and urethral catheter were recorded. All patients were followed for one year after onset, and their Glasgow Outcome Scale (GOS) scores were assessed. Long-term prognostic factors were analyzed using logistic regression.
RESULTS: The proportion of patients with traumatic brain injuries in the MCS group was higher than in the VS group (p<0.05), while hypoxic-ischemic encephalopathy accounted for a higher proportion in the VS group; the differences were statistically significant between the two groups. The occurrence of infection was the highest in both groups, followed by spasticity and epilepsy. The occurrence of other complications was slightly different between the two groups but did not reach statistical significance (p>0.05). Age, etiology, and consciousness at admission had a significant impact on the long-term prognoses of VS or MCS patients (p<0.05), and the age of onset was the most important factor (the highest OR).
CONCLUSIONS: Infection, spasticity, and epilepsy are common complications in both VS and MCS patients. Recovery of consciousness after one year was shown to be affected by age, etiology, and consciousness at admission.

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