Three-year survival rate and changes in the level of consciousness in outpatients after severe brain injuries
- Authors: Nekrasova I.Y.1, Grechko A.V.1, Kanarskii M.1, Borisov I.V.1, Pradhan P.1, Mukhin A.V.1, Yankevich D.S.1, Petrova M.V.1,2
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Affiliations:
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
- Peoples' Friendship University of Russia named after Patrice Lumumba
- Issue: Vol 17, No 3 (2023)
- Pages: 31-40
- Section: Original articles
- URL: https://journals.rcsi.science/2075-5473/article/view/253953
- DOI: https://doi.org/10.54101/ACEN.2023.3.4
- ID: 253953
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Abstract
Introduction. There is a worldwide lack of statistical data about the patients with chronic disorders of consciousness (DOC). In Russia, there are no such data at all.
Objective: to perform the first study in Russia to assess the survival rate and changes in the level of consciousness in outpatients with the chronic DOC after their hospital discharge as well as to identify the predictors of survival and improvement in the level of consciousness.
Materials and methods. All the participants (n = 142) underwent their treatment and rehabilitation in Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology from January 2016 to January 2020. We recorded the changes in patient's vital status and their level of consciousness at the endpoints of 3, 6, 12, 24, and 36 months from the brain injury (both for hospital and outpatient stages). We used the Kaplan–Meier method to assess the survival rate. We also used the logistic regression model to determine the correlation between the predictors of the survival and the improvement in the level of consciousness at baseline and 36 months after the injury.
Results. The mortality rate in the study group 3 years after the brain injury was 86.6%. Regardless of the survival rate, the level of consciousness had significantly improved (i.e., they regained communication) in 22.5% of patients within 3 years after the index event. The statistically significant final model of the regression analysis (for 142 patients) showed that younger age and higher overall CRS-R score improved the survival rate. The logistic regression model used to determine the predictors of the improvement in the level of consciousness among the survivors gave no significant results.
Conclusions. High mortality rate among the outpatients, whose level of consciousness had improved at discharge, proves the ineffectiveness of the outpatient rehabilitation. Thus, we need to find a way to improve it. The authors hope that the data obtained in this study will form the basis of their research.
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##article.viewOnOriginalSite##About the authors
Iuliia Y. Nekrasova
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: nekrasova84@yandex.ru
ORCID iD: 0000-0002-4435-8501
Cand. Sci. (Tech.), researcher, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionAndrey V. Grechko
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: nekrasova84@yandex.ru
ORCID iD: 0000-0003-3318-796X
D. Sci. (Med.), Prof., Corresponding Member of the Russian Academy of Sciences, Director, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionMikhail Kanarskii
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: kanarmm@yandex.ru
ORCID iD: 0000-0002-7635-1048
junior researcher, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionIlya V. Borisov
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: realzel@gmal.com
ORCID iD: 0000-0002-5707-118X
junior researcher, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionPranil Pradhan
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: pranilpr@gmail.com
ORCID iD: 0000-0002-3505-7504
junior researcher, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionAleksey V. Mukhin
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Author for correspondence.
Email: muhinav@fnkcrr.ru
physician, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionDmitry S. Yankevich
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: nekrasova84@yandex.ru
ORCID iD: 0000-0001-5143-7366
Cand. Sci. (Med.), Deputy Head, Research Institute of Rehabilitology for Innovations, Head, Laboratory of motor rehabilitation, restoration of swallowing and speech, Research and Clinical Center for Reanimatology and Rehabilitation, Moscow, Russia
Russian Federation, Moscow regionMarina V. Petrova
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples' Friendship University of Russia named after Patrice Lumumba
Email: mpetrova@fnkcrr.ru
ORCID iD: 0000-0003-4272-0957
D. Sci. (Med.), Prof., Deputy director for scientific and clinical activities, Research and Clinical Center for Reanimatology and Rehabili- tation, Moscow, Russia; Head, Department of anesthesiology and resuscitation, Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba, Moscow, Russia
Russian Federation, Moscow region; MoscowReferences
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