title: Life expectancy and median survival time in the permanent vegetative state.
abstract: The authors studied life expectancy and risk factors for mortality of persons in the vegetative state (VS). The study participants were 1,021 California patients in the VS during 1981-1996. Because of the large sample size, the authors were able to use multivariate methods to assess the effect of several risk factors on mortality. The authors found a strong secular trend in infant mortality, with rates in the mid-1990s being only one third of those in the early 1980s (P < 0.01). A smaller secular trend was observed for children aged 2-10 years and none for older patients. The mortality risk for older patients fell by approximately 8% for each year since the onset of the VS. The need for gastrostomy feeding was associated with a substantially higher risk, especially for infants and older patients (P < 0.01). Ventilator dependence also appeared to be a risk factor. On the basis of recent mortality rates, life expectancy in the VS is frequently higher than has generally been thought. For example, it is 10.5 additional years (+/- 2 years) for a 15-year-old patient who has been in the VS for 1 year, and 12.2 years for a 15-year-old patient who has been in the VS for 4 years.
authors.affiliation: Department of Statistics, University of California, Riverside 92521-0138, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Strauss
authors.forename: R M
authors.initials: RM
authors.lastname: Shavelle
authors.forename: S
authors.initials: S
authors.lastname: Ashwal
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D018458:Persistent Vegetative State / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate