PTOTSLPCohortArchives of physical medicine and rehabilitation2021

Very Long-Term Outcomes in Children Admitted in a Disorder of Consciousness After Severe Traumatic Brain Injury.

Sandra Rodgin, Stacy J Suskauer, Julia Chen and 3 others

PMID 33609500

WHAT IT FOUND

Most children admitted to rehab in a disorder of consciousness after severe brain injury emerged from that state by one year, but nearly all remained severely disabled.

Children in a minimally conscious state at admission had better long-term outcomes than those in a vegetative state.

Key findings

01By one year post-injury, 73% of the children had emerged from the disorder of consciousness, while 27% remained in a vegetative or minimally conscious state.

02Children who were in a minimally conscious state at admission were significantly more likely to emerge from the disorder of consciousness by the most recent follow-up (95%) compared to those in a vegetative state (69.2%).

03Despite emergence from the disorder of consciousness, most survivors remained in the lower severe disability category on the Glasgow Outcome Scale at both one year and long-term follow-up, requiring frequent caregiver assistance.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Small sample size (37 children with follow-up) from a single institution. Outcomes were rated retrospectively from clinical notes, not using standardized measures administered by the researchers. Only children who returned for follow-up were included, which may bias results toward families with better access or outcomes. The Glasgow Outcome Scale categories are broad and may miss subtle but meaningful functional improvements. Follow-up times varied widely (2 to 12 years), making direct comparisons difficult.

Declared interests

None declared.

The easy way to misread this

Do not assume that emerging from a disorder of consciousness equates to functional recovery. Most children who emerged remained severely disabled and dependent on caregivers for daily tasks. Additionally, the study did not find significant differences in later emergence between MCS+ and MCS- groups, so MCS- should not be dismissed as having no potential for emergence.

Read it on PubMed →