Six-month outcomes in patients with hemorrhagic and non-hemorrhagic traumatic disorders of consciousness.
Minimally conscious state
Neurofilament light chain
Prognosis
Traumatic brain injury
Unresponsive wakefulness syndrome
Vegetative state
Journal
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
02
04
2022
accepted:
08
08
2022
pubmed:
18
8
2022
medline:
2
11
2022
entrez:
17
8
2022
Statut:
ppublish
Résumé
Intracranial hematomas (IHs) occur commonly after severe traumatic brain injury, but their effects on outcomes in patients with prolonged disorders of consciousness (DoC) following coma (i.e., unresponsive wakefulness syndrome and minimally conscious state) are unknown. In this multicenter longitudinal study, we compared clinical outcomes and serum neurofilament light chain (NFL) levels of 52 patients with traumatic DoC with (n = 35) and without (n = 17) IH in the acute phase. Patients were evaluated with the Coma Recovery Scale-Revised (CRS-R) at enrollment (1-3 months post-injury) and with the CRS-R, extended Glasgow Outcome Scale (GOSE), and Functional Independence Measure (FIM) at 6 months post-injury. At the same timepoints, serum NFL levels were compared between patients with and without IHs and with those of 52 sex- and age-matched healthy controls. Patients with and without IH did not differ in terms of DoC or CRS-R scores at admission, or clinical outcomes (death, unresponsive wakefulness syndrome, minimally conscious state, or emergence from minimally conscious state) or CRS-R, GOSE, or FIM scores 6 months post-injury. NFL levels were significantly higher in patients than in controls at admission and 6 months post-injury (both p < 0.0001), but they did not differ between patients with and without IH. This study showed that IHs do not affect clinical outcomes or markers of axonal degeneration in patients with traumatic DoC.
Sections du résumé
BACKGROUND
BACKGROUND
Intracranial hematomas (IHs) occur commonly after severe traumatic brain injury, but their effects on outcomes in patients with prolonged disorders of consciousness (DoC) following coma (i.e., unresponsive wakefulness syndrome and minimally conscious state) are unknown.
METHODS
METHODS
In this multicenter longitudinal study, we compared clinical outcomes and serum neurofilament light chain (NFL) levels of 52 patients with traumatic DoC with (n = 35) and without (n = 17) IH in the acute phase. Patients were evaluated with the Coma Recovery Scale-Revised (CRS-R) at enrollment (1-3 months post-injury) and with the CRS-R, extended Glasgow Outcome Scale (GOSE), and Functional Independence Measure (FIM) at 6 months post-injury. At the same timepoints, serum NFL levels were compared between patients with and without IHs and with those of 52 sex- and age-matched healthy controls.
RESULTS
RESULTS
Patients with and without IH did not differ in terms of DoC or CRS-R scores at admission, or clinical outcomes (death, unresponsive wakefulness syndrome, minimally conscious state, or emergence from minimally conscious state) or CRS-R, GOSE, or FIM scores 6 months post-injury. NFL levels were significantly higher in patients than in controls at admission and 6 months post-injury (both p < 0.0001), but they did not differ between patients with and without IH.
CONCLUSIONS
CONCLUSIONS
This study showed that IHs do not affect clinical outcomes or markers of axonal degeneration in patients with traumatic DoC.
Identifiants
pubmed: 35978256
doi: 10.1007/s10072-022-06335-x
pii: 10.1007/s10072-022-06335-x
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6511-6516Informations de copyright
© 2022. Fondazione Società Italiana di Neurologia.
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