Liu Yan, Kang Xiao-Gang, Gao Qiong, Liu Yu, Song Chang-Geng, Shi Xiao-Jing, Wu Jia-Ning, Jiang Wen
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Brain Sci. 2023 Jan 23;13(2):194. doi: 10.3390/brainsci13020194.
To evaluate the long-term survival and functional outcomes of patients with prolonged disorders of consciousness (pDoC) 1-8 years after brain injuries.
Retrospective study to assess the long-term survival and functional outcomes of patients with pDoC was conducted. We performed Cox regression and multivariate logistic regression to calculate hazard ratios (HRs) for the outcome of survival and to identify risk factors of the functional outcome.
We recruited 154 patients with pDoC. The duration of follow-up from disease onset was 1-8 years. The median age was 46 years (IQR, 32-59), and 65.6% ( = 101) of them were men. During the follow-up period, one hundred and ten patients (71.4%) survived; among them, 52 patients had a good outcome. From the overall survival curve, the 1-, 3-, and 8-year survival rates of patients were about 80.5%, 72.0%, and 69.7%, respectively. Cox regression analysis revealed a significant association between the lower APACHE II score ( = 0.005) (cut-off score ≥ 18) and the presence of sleep spindles ( = 0.001) with survival. Logistic regression analysis demonstrated a higher CRS-R score (cut-off score ≥ 7), and presence of sleep spindles were related to a favorable outcome among patients with pDoC.
Sleep spindles are correlated with both long-term survival and long-term functional outcome in pDoC patients.
评估脑损伤后意识障碍持续时间延长（pDoC）1 - 8年患者的长期生存率和功能预后。
进行了一项回顾性研究，以评估pDoC患者的长期生存率和功能预后。我们进行了Cox回归和多变量逻辑回归，以计算生存结局的风险比（HRs），并确定功能结局的危险因素。
我们招募了154例pDoC患者。从疾病发作开始的随访时间为1 - 8年。中位年龄为46岁（四分位间距，32 - 59岁），其中65.6%（n = 101）为男性。在随访期间，110例患者（71.4%）存活；其中52例患者预后良好。从总体生存曲线来看，患者的1年、3年和8年生存率分别约为80.5%、72.0%和69.7%。Cox回归分析显示，较低的急性生理与慢性健康状况评分系统II（APACHE II）评分（P = 0.005）（临界值≥18）和睡眠纺锤波的存在（P = 0.001）与生存相关。逻辑回归分析表明，较高的昏迷恢复量表修订版（CRS - R）评分（临界值≥7）以及睡眠纺锤波的存在与pDoC患者的良好预后相关。
睡眠纺锤波与pDoC患者的长期生存和长期功能预后均相关。
