Disorders of consciousness after severe traumatic brain injury: a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways

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Fältnamn	Indikatorer	Metadata
000		05162naa a2200565 4500
001		oai:DiVA.org:uu-211908
003		SwePub
008		131203s2013 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:DiVA.org:umu-83647
009		oai:prod.swepub.kib.ki.se:127679892
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2119082 URI
024	7	a https://doi.org/10.2340/16501977-11672 DOI
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-836472 URI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1276798922 URI
040		a (SwePub)uud (SwePub)umud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Godbolt, Alison K.u Karolinska Institutet,Uppsala universitet,Rehabiliteringsmedicin4 aut0 (Swepub:uu)aligo536
245	1 0	a Disorders of consciousness after severe traumatic brain injury :b a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways
264	1	b Medical Journals Sweden AB,c 2013
338		a print2 rdacarrier
520		a Background: Very severe traumatic brain injury may cause disorders of consciousness in the form of coma, unresponsive wakefulness syndrome (also known as vegetative state) or minimally conscious state. Previous studies of outcome for these patients largely pre-date the 2002 definition of minimally conscious state. Objectives: To establish the numbers of patients with disorder of consciousness at 3 weeks, 3 months and 1 year after severe traumatic brain injury, and to relate conscious state 3 weeks after injury to outcomes at 1 year. Design: Multi-centre, prospective, observational study of severe traumatic brain injury. Inclusion criteria: lowest (non-sedated) Glasgow Coma Scale 3-8 during the first 24 h; requirement for neurosurgical intensive care; age 18-65 years; alive 3 weeks after injury. Diagnosis of coma, unresponsive wakefulness syndrome, minimally conscious state or emerged from minimally conscious state was based on clinical and Coma Recovery Scale Revised assessments 3 weeks, 3 months and 1 year after injury. One-year outcome was measured with Glasgow Outcome Scale Extended (GOSE). Results: A total of 103 patients was included in the study. Of these, 81% were followed up to 1 year (76% alive, 5% dead). Three weeks after injury 36 were in coma, unresponsive wakefulness syndrome or minimally conscious state and 11 were anaesthetized. Numbers of patients who had emerged from minimally conscious state 1 year after injury, according to status at 3 weeks were: coma (0/6), unresponsive wakefulness syndrome (9/17), minimally conscious state (13/13), anaesthetized (9/11). Outcome at 1 year was good (GOSE>4) for half of patients in minimally conscious state or anaesthetized at 3 weeks, but for none of the patients in coma or unresponsive wakefulness syndrome. These differences in outcome were not revealed by prognostic predictions based on acute data. Conclusion: Patients in minimally conscious state or anaesthetized 3 weeks after injury have a better prognosis than patients in coma or unresponsive wakefulness syndrome, which could not be explained by acute prognostic models.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskap0 (SwePub)3032 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciences0 (SwePub)3032 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Neurologi0 (SwePub)302072 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Neurology0 (SwePub)302072 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi0 (SwePub)303022 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Public Health, Global Health, Social Medicine and Epidemiology0 (SwePub)303022 hsv//eng
653		a traumatic brain injury
653		a prognosis
653		a vegetative state
653		a minimally conscious state
653		a outcome
653		a care pathways
700	1	a DeBoussard, Catharine Nygrenu Karolinska Institutet4 aut
700	1	a Stenberg, Maudu Umeå universitet,Rehabiliteringsmedicin,Arcum4 aut0 (Swepub:umu)mast0219
700	1	a Lindgren, Marie4 aut
700	1	a Ulfarsson, Trandur4 aut
700	1	a Borg, Jorgenu Karolinska Institutet4 aut
710	2	a Uppsala universitetb Rehabiliteringsmedicin4 org
773	0	t Journal of Rehabilitation Medicined : Medical Journals Sweden ABg 45:8, s. 741-748q 45:8<741-748x 1650-1977x 1651-2081
856	4	u https://doi.org/10.2340/16501977-1167y Fulltext
856	4	u https://www.medicaljournals.se/jrm/content_files/download.php?doi=10.2340/16501977-1167
856	4	u https://umu.diva-portal.org/smash/get/diva2:675453/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-211908
856	4 8	u https://doi.org/10.2340/16501977-1167
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-83647
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:127679892

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Av författaren/redakt...: Godbolt, Alison ...; DeBoussard, Cath ...; Stenberg, Maud; Lindgren, Marie; Ulfarsson, Trand ...; Borg, Jorgen

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