Childs N L, Mercer W N, Childs H W
Healthcare Rehabilitation Center, Austin, TX 78745.
Neurology. 1993 Aug;43(8):1465-7. doi: 10.1212/wnl.43.8.1465.
We reviewed pre-admission diagnosis in all patients referred for inpatient brain injury neurorehabilitation over a 5-year period (n = 193). All patients more than 1 month postinjury with diagnosis of coma or persistent vegetative state were selected for review (n = 49). We found that 18 (37%) of these patients were diagnosed inaccurately. Inaccurate diagnosis was more likely if the injury was more than 3 months before admission and the etiology of injury was trauma (48%). Results were statistically significant when traumatic injuries were compared with anoxic injuries (p < 0.10). Errors in diagnosis may result from confusion in terminology, lack of extended observation of patients, and lack of skill or training in the assessment of neurologically devastated patients.
我们回顾了5年间（n = 193）转至住院脑损伤神经康复科的所有患者的入院前诊断。选取了所有伤后超过1个月且诊断为昏迷或持续性植物状态的患者进行回顾（n = 49）。我们发现这些患者中有18例（37%）诊断不准确。如果损伤发生在入院前3个月以上且损伤病因是创伤，则误诊的可能性更大（48%）。将创伤性损伤与缺氧性损伤进行比较时，结果具有统计学意义（p < 0.10）。诊断错误可能是由于术语混淆、对患者缺乏长期观察以及在评估神经功能严重受损患者方面缺乏技能或培训所致。
