Severe disorders of consciousness after acquired brain injury: A single-centre long-term follow-up study

To assess long-term clinical outcome, functional independence and health-related quality of life (HRQOL) in acquired brain injury (ABI) patients with a disorder of consciousness at admission to inpatient rehabilitation.

We selected patients from a cohort of ABI patients from a single centre. In addition to mortality, we measured level of consciousness with the Coma Remission Scale, functional independence with the Barthel Index, as well as generic and condition-specific HRQOL with the EQ5D and the "Quality of Life after Brain Injury" (QOLIBRI) respectively.

Half of the obtained sample had died by follow-up. Survivors were younger at onset, in a minimally conscious state (MCS) at admission and had spent longer time in rehabilitation. Patients in a MCS were more likely to survive, and be in a state better than MCS over the follow-up time than patients with an unresponsive wakefulness syndrome (UWS). A small proportion of patients with UWS at admission emerged from MCS at follow-up. Emergence from MCS was associated with traumatic brain injury (TBI) and higher functional independence.

Clinical outcome is mostly concordant with previous findings. Survivors' rehabilitation duration suggest revision of current standards. HRQOL results indicate a correlation with functional independence and that condition-specific HRQOL should not be neglected.