PDF(Pubmed)
Abstract：
The minimally conscious state (MCS) is a prolonged disorder of consciousness (pDoC) and one of the most severe outcomes of acquired brain injury. Prevalence data are scarce. The aim of this study was to establish the nationwide point prevalence of institutionalized patients in MCS in the Netherlands.
This was a descriptive cross-sectional study in which all 86 Dutch hospitals, all 5 specialized pDoC rehabilitation facilities, and all 274 nursing homes were asked whether they were treating patients with a pDoC on the point prevalence date of September 15, 2021. Each patient\'s legal representative provided informed consent for their inclusion. Patient level of consciousness was verified using the Coma Recovery Scale-Revised (CRS-R) in a single assessment session performed in the facility of residence by an experienced physician. Data on patient demographics, etiology, level of consciousness, facility of residence, and clinical status were collected from a questionnaire by the treating physician. The prevalence of institutionalized patients in MCS of per 100,000 members of the Dutch population was calculated, based on actual census data.
Seventy patients were reported to have a pDoC, of whom 6 were excluded. The level of consciousness was verified for 49 patients while for 15, it could not be verified. Of the patients verified, 38 had a pDoC, of whom 32 were in MCS (mean age 44.8 years, 68.8% male). The prevalence of institutionalized patients in MCS is 0.2-0.3 per 100,000 Dutch inhabitants. Traumatic brain injury was present in 21 of 32 patients (65.6%). Specialized pDoC rehabilitation was received by 17 of 32 patients (53%), with the rest admitted to nursing homes. The most frequent signs of consciousness on the CRS-R were visual pursuit, reproducible movement to command, and automatic motor response.
This nationwide study revealed a low prevalence of institutionalized patients in MCS in the Netherlands. These findings are now being used to organize pDoC care in this country.
This was a descriptive cross-sectional study in which all 86 Dutch hospitals, all 5 specialized pDoC rehabilitation facilities, and all 274 nursing homes were asked whether they were treating patients with a pDoC on the point prevalence date of September 15, 2021. Each patient\'s legal representative provided informed consent for their inclusion. Patient level of consciousness was verified using the Coma Recovery Scale-Revised (CRS-R) in a single assessment session performed in the facility of residence by an experienced physician. Data on patient demographics, etiology, level of consciousness, facility of residence, and clinical status were collected from a questionnaire by the treating physician. The prevalence of institutionalized patients in MCS of per 100,000 members of the Dutch population was calculated, based on actual census data.
Seventy patients were reported to have a pDoC, of whom 6 were excluded. The level of consciousness was verified for 49 patients while for 15, it could not be verified. Of the patients verified, 38 had a pDoC, of whom 32 were in MCS (mean age 44.8 years, 68.8% male). The prevalence of institutionalized patients in MCS is 0.2-0.3 per 100,000 Dutch inhabitants. Traumatic brain injury was present in 21 of 32 patients (65.6%). Specialized pDoC rehabilitation was received by 17 of 32 patients (53%), with the rest admitted to nursing homes. The most frequent signs of consciousness on the CRS-R were visual pursuit, reproducible movement to command, and automatic motor response.
This nationwide study revealed a low prevalence of institutionalized patients in MCS in the Netherlands. These findings are now being used to organize pDoC care in this country.
摘要：
目的：最低意识状态（MCS）是一种长时间的意识障碍（pDoC），是获得性脑损伤最严重的结果之一。患病率数据很少。这项研究的目的是在荷兰建立全国范围内MCS住院患者的流行率。
方法：这是一项描述性的横断面研究，其中所有86家荷兰医院，所有五个专业的pDoC康复设施，所有274家的疗养院都被问及他们是否在2021年9月15日的流行日期治疗pDoC患者。每位患者的法定代表人都提供了知情同意书。患者意识水平使用昏迷恢复量表修订（CRS-R）在有经验的医生在居住设施中进行的单个评估会话中进行验证。患者人口统计数据，病因学,意识水平,居住设施,和临床状态由治疗医师从问卷中收集。计算了每100,000名荷兰人口中MCS制度化的患病率，根据实际的人口普查数据。
结果：据报道有70例患者患有pDoC，其中6人被排除在外。对49例患者的意识水平进行了验证，而15则无法核实。在被证实的病人中，38有一个pDoC，其中32人在MCS中(平均年龄44.8岁，68.8%男性）。MCS中住院患者的患病率为0.2-0.3/100,000荷兰居民。这些患者中有21/32（65.6％）存在创伤性脑损伤。17/32（53％）的患者接受了专业的pDoC康复治疗，其余的人被送进疗养院。CRS-R上最常见的意识迹象是视觉追求，可重复的运动到命令，和自动马达响应。
结论：这项全国性的研究显示，在荷兰，MCS住院患者的患病率较低。这些发现现在被用来组织这个国家的pDoC护理。
方法：这是一项描述性的横断面研究，其中所有86家荷兰医院，所有五个专业的pDoC康复设施，所有274家的疗养院都被问及他们是否在2021年9月15日的流行日期治疗pDoC患者。每位患者的法定代表人都提供了知情同意书。患者意识水平使用昏迷恢复量表修订（CRS-R）在有经验的医生在居住设施中进行的单个评估会话中进行验证。患者人口统计数据，病因学,意识水平,居住设施,和临床状态由治疗医师从问卷中收集。计算了每100,000名荷兰人口中MCS制度化的患病率，根据实际的人口普查数据。
结果：据报道有70例患者患有pDoC，其中6人被排除在外。对49例患者的意识水平进行了验证，而15则无法核实。在被证实的病人中，38有一个pDoC，其中32人在MCS中(平均年龄44.8岁，68.8%男性）。MCS中住院患者的患病率为0.2-0.3/100,000荷兰居民。这些患者中有21/32（65.6％）存在创伤性脑损伤。17/32（53％）的患者接受了专业的pDoC康复治疗，其余的人被送进疗养院。CRS-R上最常见的意识迹象是视觉追求，可重复的运动到命令，和自动马达响应。
结论：这项全国性的研究显示，在荷兰，MCS住院患者的患病率较低。这些发现现在被用来组织这个国家的pDoC护理。
