Schnetzer Laura, Prüwasser Tanja, Bergmann Jürgen, Zimmermann Georg, Kronbichler Martin, Leis Stefan, Trinka Eugen
Department of Neurology, Neurological Intensive Care and Neurorehabilitation, Christian Doppler Medical Centre, Centre for Cognitive Neuroscience Salzburg, Member of the European Reference Network EpiCARE, Paracelsus Medical University, Salzburg, Austria.
Neuroscience Institute, Christian Doppler Medical Centre, Centre for Cognitive Neuroscience Salzburg, Paracelsus Medical University, Salzburg, Austria.
Front Neurol. 2024 Dec 2;15:1465564. doi: 10.3389/fneur.2024.1465564. eCollection 2024.
Epidemiological data on disorders of consciousness (DoC) is rare and very heterogeneous due to difficulties in case ascertainment and differences in health care pathways between countries. This study reports data on mortality and survival time for DoC patients in Salzburg, Austria.
All patients with DoC were registered in the health care region of Salzburg North, Austria between 2007 and 2022 and their death data retrieved from the Statistik Austria. The 1- and 5-year mortality was calculated, also in relation to several explanatory variables (age, sex, etiology, diagnosis, CRS-R score, improvement). Furthermore, the incidence, survival functions using the Kaplan-Meier estimator and a Cox-Regression were calculated.
The mean annual incidence is 2.2 DoC/100.000 inhabitants in the Salzburg North region. The crude 1- and 5-year mortality rates were 25.9 and 55.1%, respectively, and the median survival of DoC patients based on the Kaplan-Meier estimator was 6.3 years. Moreover, the mortality was lower in women and in younger patients, those of traumatic etiology, and those with higher CRS-R scores, better diagnosis or an improvement of diagnosis until discharge from hospital.
This article gives a rare insight into epidemiological data on DoC and shows which factors influence the mortality of these patients. Moreover, it is the first community based study on mortality of DoC in Salzburg, Austria.
由于病例确诊困难以及各国医疗保健途径存在差异,关于意识障碍(DoC)的流行病学数据很少且非常不一致。本研究报告了奥地利萨尔茨堡DoC患者的死亡率和生存时间数据。
2007年至2022年期间,奥地利萨尔茨堡北部医疗保健区域登记了所有DoC患者,并从奥地利统计局获取了他们的死亡数据。计算了1年和5年死亡率,并与几个解释变量(年龄、性别、病因、诊断、CRS-R评分、病情改善情况)进行了关联分析。此外,还计算了发病率、使用Kaplan-Meier估计器的生存函数以及Cox回归。
萨尔茨堡北部地区DoC的年平均发病率为每10万居民中有2.2例。粗略的1年和5年死亡率分别为25.9%和55.1%,基于Kaplan-Meier估计器的DoC患者中位生存期为6.3年。此外,女性、年轻患者、创伤性病因患者、CRS-R评分较高患者、诊断较好或直至出院时诊断有所改善的患者死亡率较低。
本文罕见地深入探讨了DoC的流行病学数据,并显示了哪些因素会影响这些患者的死亡率。此外,这是奥地利萨尔茨堡第一项基于社区的DoC死亡率研究。