Prognostic factors in prolonged disorders of consciousness: a narrative review

Elucidating the factors that influence the recovery of impaired consciousness in patients with prolonged disorders of consciousness (pDoC) is essential for guiding neurorehabilitation strategies and improving prognostic accuracy. This review synthesizes evidence from multiple studies that investigated prognostic factors in pDoC using various approaches, including clinical and demographic characteristics, biomarkers, behavioral assessments, pharmacological treatments, neuromodulation techniques, neuroimaging, and electroencephalography. Results indicate that several indicators show significant correlations with functional outcomes at follow-up intervals ranging from 2 months to several years. These findings assist in selecting appropriate assessment tools and support clinical decision-making for pDoC patients. However, limitations such as small sample sizes, absence of control groups, and heterogeneity in follow-up durations were noted across studies. The development of large-scale, multimodal prognostic models is warranted to enhance clinical applicability and predictive power.