Division of Critical Care Neurology, Mayo Clinic, Rochester, MN 55905, United States.
Resuscitation. 2012 Aug;83(8):940-5. doi: 10.1016/j.resuscitation.2012.03.020. Epub 2012 Mar 21.
Persistent coma from a major anoxic-ischemic injury to the brain may indicate there is less chance for full recovery. The tools of prognostication to assess comatose survivors of cardiopulmonary resuscitation have developed over several decades. Physicians would initially base their judgment on experience and data on outcome in these patients in the early years were merely on awakening not on disability. In the late 1970s, a large multicenter prospective study was performed on outcome in nontraumatic coma. The impetus for this study was the result of Plum and Jennet's collaboration. In 1981--for the first time--complex statistics were used to improve the accuracy of prognosis and became known as the "Levy algorithms." These early seminal studies shaped the prediction models and implied that clinical information alone could assist physicians in making a prediction. Later, probabilistic methods became more commonplace.
持续性昏迷表明大脑受到严重缺氧缺血性损伤，患者可能很难完全康复。对心肺复苏后昏迷幸存者进行预后评估的工具经过几十年的发展已经逐渐完善。最初，医生会根据经验和早期患者的预后数据做出判断，而当时的预后数据仅仅是基于患者的苏醒情况，而不是残疾情况。20 世纪 70 年代末，一项关于非创伤性昏迷患者预后的大型多中心前瞻性研究进行。这项研究的动机源于 Plum 和 Jennet 的合作。1981 年——首次——复杂的统计学方法被用于提高预后的准确性，这些方法被称为“Levy 算法”。这些早期的开创性研究形成了预测模型，并暗示仅临床信息就能帮助医生做出预测。后来，概率方法变得更加常见。
