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处于持续性植物状态儿童的预期寿命。

Life expectancy of children in a persistent vegetative state.

作者信息

Ashwal S, Eyman R K, Call T L

机构信息

Department of Pediatrics, Loma Linda University School of Medicine, CA 92350.

出版信息

Pediatr Neurol. 1994 Feb;10(1):27-33. doi: 10.1016/0887-8994(94)90063-9.

Abstract

The persistent vegetative state (PVS) is a state of wakeful unconsciousness occurring in adults and children. Despite preservation of vegetative functions, PVS patients have a shortened life-span, although accurate information concerning this issue remains limited. The survival of children in PVS was examined to determine whether age, etiology of the vegetative state, or type of residence in which the patient lived affected the estimated survival. The data of 155,851 developmentally disabled California state residents were reviewed using the Client Development Evaluation Report (CDER). Criteria from the CDER were selected to define the vegetative state and included: lack of interaction with peers; absence of auditory, visual, and expressive or receptive language function; no hand or arm use; inability to eat, sit, roll over, or lift head; and no bowel or bladder control. There were 847 patients who met these criteria on the initial and follow-up CDERs. A product limit survival model was used to develop survival curves and to calculate the median survival time for patients grouped by age, etiology, and type of residence. Median survival (yrs) for patients who remained in PVS for the following age groups was: < 1 yr: 2.6, 1 < 2 yrs: 4.2, 2-6 yrs: 5.2, 7-18 yrs: 7.0, > or = 19 yrs: 9.9. Median survival based on etiology varied from 3.0 to 8.6 years; no consistent relationship existed between etiology and duration of survival. Survival (yrs) for patients younger than age 18 years based on type of residence included: own home: 4.5, institutions: 5.2, skilled nursing facility/private hospital: 3.2, and other community care facilities: 3.7.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

持续性植物状态(PVS)是一种发生于成人和儿童的觉醒性昏迷状态。尽管保留了植物性功能,但PVS患者的寿命缩短,不过关于这个问题的准确信息仍然有限。对PVS患儿的存活情况进行了研究,以确定年龄、植物状态的病因或患者居住的住所类型是否会影响估计的存活时间。使用客户发展评估报告(CDER)对155,851名加利福尼亚州发育障碍居民的数据进行了回顾。从CDER中选择标准来定义植物状态,包括:与同龄人缺乏互动;听觉、视觉以及表达性或接受性语言功能缺失;不使用手或手臂;无法进食、坐立、翻身或抬头;以及无大小便控制能力。在初次和后续的CDER中有847名患者符合这些标准。使用乘积限生存模型来绘制生存曲线,并计算按年龄、病因和住所类型分组的患者的中位生存时间。处于PVS状态的以下年龄组患者的中位生存时间(年)为:<1岁:2.6,1 - 2岁:4.2,2 - 6岁:5.2,7 - 18岁:7.0,≥19岁:9.9。基于病因的中位生存时间从3.0年到8.6年不等;病因与生存持续时间之间不存在一致的关系。基于住所类型,18岁以下患者的生存时间(年)包括:自己家中:4.5,机构:5.2,专业护理机构/私立医院:3.2,以及其他社区护理机构:3.7。(摘要截断于250字)

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