Recovery From Vegetative State: A Four-Years Follow Up

Although the general observation that the longer the duration of the vegetative state, the lower the probability of emerging from it remains true, reports of late improvement are ever more common in the literature. The aim of this study was to verify evolution from Vegetative State in a group of inpatients in a Neurorehabilitation facility and to identify the parameters increasing the likelihood of transition to a Minimally Conscious State. A retrospective review of 259 patients admitted consecutively suffering the sequelae of a severe brain injury (initial Glasgow Coma Scale ≤ 8) was performed to evaluate course of recovery during hospitalisation and in follow-up, 1-4 years post-injury. In our series of 75 patients admitted in a Vegetative State and undergoing neurorehabilitation, 10 were still in a Vegetative State 36 months after the acute event and were observed until 48 months after their admission to the Vegetative State Unit. In the last 12 months of observation, 2 patients died, 5 remained in a Vegetative State and 3 were showing signs of improved consciousness.Univariate analysis identified the parameters increasing the likelihood of transition to a Minimally Conscious State as male sex, youth, shorter time from the onset of Vegetative Sxtate, presence of widespread injury and presence of status epilepticus.