Dysautonomia and Clinical Outcome in Vegetative State.
A dramatic disorder tentatively attributed to diencephalic-hypothalamic damage or dysfunction, dysautonomia, affects recovery from brain injury. Its incidence, correlation with etiology, and relevance as a predictor of outcome were retrospectively surveyed in 333 patients in vegetative state (VS) for more than 2 weeks at admission. Outcome was assessed according to the Glasgow Outcome Scale. Data were treated statistically by multi-variate analyses. Dysautonomia occurred in 26.1% of patients, with greater incidence among post-traumatic (31.9%) than non-traumatic (15.8%) patients. Outcome was worse among non-traumatic than post-traumatic patients irrespective of dysautonomia, and worst among non-traumatic patients with dysautonomia. Dysautonomia proved common among patients in VS (with incidence depending on etiology and age) and influenced the patients' outcome through mechanisms still to be defined, but conceivably mediated by diencephalic-hypothalamic unbalance.
Dolce
Giuliano
G
Sant'Anna Institute, Crotone, Italy.
Quintieri
Maria
M
Sant'Anna Institute, Crotone, Italy.
Leto
Elio
E
Sant'Anna Institute, Crotone, Italy.
Milano
Michele
M
Sant'Anna Institute, Crotone, Italy.
Pileggi
Antonio
A
Sant'Anna Institute, Crotone, Italy.
Lagani
Vincenzo
V
Department of Electronic, Informatics and Systemistics, University of Calabria, Cosenza, Italy.
Pignolo
Loris
L
Department of Electronic, Informatics and Systemistics, University of Calabria, Cosenza, Italy.
D000328:Adult; D000368:Aged; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000150:complications*; D054969:Primary Dysautonomias / Q000453:epidemiology*; D012189:Retrospective Studies