Causes and Outcomes of Persistent Vegetative State in a Chinese Versus American Referral Hospital

详细信息    查看全文

• 作者：Farrah J. Mateen (1) (2)
  Jing-Wen Niu (3)
  Shan Gao (3)
  Shun-Wei Li (3)
  Marco Carone (4)
  Eelco F. M. Wijdicks (5)
  Wei-Hai Xu (3)
  
• 关键词：Coma ; Vegetative state ; Cardiac arrest ; China ; Consciousness ; Stroke
• 刊名：Neurocritical Care
• 出版年：2013
• 出版时间：April 2013
• 年：2013
• 卷：18
• 期：2
• 页码：266-270
• 全文大小：180KB
• 参考文献：1. Beaumont JG, Kenealy PM. Incidence and prevalence of the vegetative and minimally conscious states. Neuropsychol Rehabil. 2005;15:184-. CrossRef
  2. Higashi K, Sakata Y, Hatano M, et al. Epidemiological studies on patients with a persistent vegetative state. J Neurol Neurosurg Psychiatry. 1977;40:876-5. CrossRef
  3. Higashi K, Hatano M, Abiko S, et al. Five-year follow-up study of patients with persistent vegetative state. J Neurol Neurosurgery Psychiatry. 1981;44:552-. CrossRef
  4. Andrews K. Recovery of patients after four months or more in the persistent vegetative state. BMJ. 1999;306:1597-00. CrossRef
  5. Donis J, Kr?ftner B. The prevalence of patients in a vegetative state and minimally conscious state in nursing homes in Austria. Brain Inj. 2011;25:1101-. CrossRef
  6. American Academy of Neurology. Practice parameters: assessment and management of patients in the persistent vegetative state. Report of the Quality Standards Subcommittee of the American Academy of Neurology, 1995. http://www.aan.com/professionals/practice/pdfs/pdf_1995_thru_1998/1995.45.1015.pdf. Last Accessed 22 July 2012.
  7. Zhang L, Yang J, Hong Z, et al. Proportion of different subtypes of stroke in China. Stroke. 2003;34:2091-. CrossRef
  8. Andersen KK, Olsen TS, Dehlendorff C, et al. Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors. Stroke. 2009;40:2068-2. CrossRef
  9. Wu Y, Huxley R, Liming L, for the China NNHS Steering Committee and the China NNHS Working Group, et al. Prevalence, awareness, treatment, and control of hypertension in China. Data from the China National Nutrition and Health Survey 2002. Circulation. 2008;118:2679-6. CrossRef
  10. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457-1. CrossRef
  11. Reuters. Congested Beijing adds 1,466 cars to its roads each day. Feb. 17, 2009.
  12. Mayer SA, Kossoff SB. Withdrawal of life support in the neurological intensive care unit. Neurology. 1999;52:1602-. CrossRef
  13. World Health Organization. “Disability and Health-Fact Sheet no. 352. http://www.who.int/mediacentre/factsheets/fs352/en/index.html. Accessed June 2011.
  14. Mateen FJ. Neurocritical care in developing countries. Neurocrit Care. 2011;15:593-. CrossRef
  
• 作者单位：Farrah J. Mateen (1) (2)
  Jing-Wen Niu (3)
  Shan Gao (3)
  Shun-Wei Li (3)
  Marco Carone (4)
  Eelco F. M. Wijdicks (5)
  Wei-Hai Xu (3)
  
  1. Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Room E8527, 600 North Wolfe Street, Baltimore, MD, 21205, USA
  2. Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA
  3. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Beijing, China
  4. Division of Biostatistics, University of California at Berkeley, Berkeley, CA, USA
  5. Department of Neurology, Mayo Clinic, Rochester, MN, USA
  

文摘

Objective To compare the etiologies and clinical outcomes of patients in a persistent vegetative state (PVS) between a Chinese and US referral hospital. Methods A retrospective, observational study at the Peking Union Medical College Hospital, Beijing, China and Johns Hopkins Hospital, Baltimore, USA (2001-010) was performed. Results There were 36 cases of PVS diagnosed. In Beijing, there were 19 cases: mean age 57?years, range 3-6, (42?%) female, with 37?% of patients observed to survive more than 1?year (range >1?month to >28?years, median >6?months). Causes of PVS in Beijing were hemorrhagic stroke (n?=?4, 21?%), ischemic stroke (n?=?2, 11?%), cardiac arrest (n?=?5, 26?%, including 4 with attempted cardiopulmonary resuscitation (CPR)), traumatic brain injury (n?=?3, 16?%), and one each of mitochondrial encephalomyopathy, acute disseminated encephalomyelitis, Lennox Gastaut Syndrome, and epilepsy with craniopharyngioma (n?=?4, 21?%). In Baltimore, there were 17 cases of PVS: mean age 43?years, range 15-3, 59?% female, with 41?% observed to survive more than 1?year (range >1?month to >10?years, median >3?years). Causes of PVS in Baltimore were ischemic stroke (n?=?3, 18?%), cardiac arrest (n?=?3, 18?%, including one with attempted CPR), traumatic brain injury (n?=?3, 18?%), neurodegenerative conditions (n?=?2, 12?%), and hypoxic ischemic encephalopathy due to respiratory arrest (n?=?3, 18?%), metabolic derangements (n?=?2, 12?%), and meningitis (n?=?1, 6?%). Conclusions There may be a long survival period for patients with PVS, including in China where resource constraints exist for acute neurologic care. Stroke appears to be the most common underlying cause of PVS in Chinese patients, followed closely by cardiac arrest with attempted CPR. There appear to be more varied causes of PVS in the US referral hospital with a predominance of stroke, cardiac arrest, and traumatic brain injury.