title: Severe disorders of consciousness after acquired brain injury: A single-centre long-term follow-up study.
abstract: OBJECTIVE
  To assess long-term clinical outcome, functional independence and health-related quality of life (HRQOL) in acquired brain injury (ABI) patients with a disorder of consciousness at admission to inpatient rehabilitation.
  
  
  METHODS
  We selected patients from a cohort of ABI patients from a single centre. In addition to mortality, we measured level of consciousness with the Coma Remission Scale, functional independence with the Barthel Index, as well as generic and condition-specific HRQOL with the EQ5D and the "Quality of Life after Brain Injury" (QOLIBRI) respectively.
  
  
  RESULTS
  Half of the obtained sample had died by follow-up. Survivors were younger at onset, in a minimally conscious state (MCS) at admission and had spent longer time in rehabilitation. Patients in a MCS were more likely to survive, and be in a state better than MCS over the follow-up time than patients with an unresponsive wakefulness syndrome (UWS). A small proportion of patients with UWS at admission emerged from MCS at follow-up. Emergence from MCS was associated with traumatic brain injury (TBI) and higher functional independence.
  
  
  CONCLUSIONS
  Clinical outcome is mostly concordant with previous findings. Survivors' rehabilitation duration suggest revision of current standards. HRQOL results indicate a correlation with functional independence and that condition-specific HRQOL should not be neglected.
authors.affiliation: Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Alex
authors.initials: A
authors.lastname: Lopez-Rolon
authors.affiliation: Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Vogler
authors.affiliation: Harvard Medical School, Harvard University, Boston, MA, USA.
authors.forename: Kaitlen
authors.initials: K
authors.lastname: Howell
authors.affiliation: Department of Mathematics and Applied Mathematics, University of Cape Town, Cape Town, South Africa.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shock
authors.affiliation: Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Czermak
authors.affiliation: Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Suzette
authors.initials: S
authors.lastname: Heck
authors.affiliation: Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Straube
authors.affiliation: Department of Neurology, University of Munich, Munich, Germany.|Department of Neurology, Therapiezentrum Burgau, Burgau, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bender
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003244:Consciousness Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Acquired brain injury; disorders of consciousness; health-related quality of life; long-term outcome