Vegetative state in two Italian residential facilities: study of prognosis for subjects and related caregivers.
Elisabetta Pupillo, Andrea Magnoni, Lorenzo Tinti, Serena Sassi, Ambrogio Monti, Jessica Barbieri, Andrea Millul, Maria Rita Aldeghi, Elisa Bianchi
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology April 30, 2025 DOI: 10.1007/s10072-025-08205-8 via PubMed
Summary
AI-generated from the abstractAmong patients in a vegetative state (VS) treated at two long-term care facilities in Lombardy starting in 2014, non-traumatic cerebral hemorrhage was the most common cause (41%), followed by traumatic brain injury (19%) and anoxic brain injury (17%). Cumulative mortality after the event causing VS was 10% at 1 year, 24% at 2 years, 43% at 5 years, 69% at 10 years, and 88% at 15 years, with older age and ischemic stroke increasing risk. Among 24 caregivers, 50% had scores recommending psychological support, 33% strongly recommended support, and 13% urgent need. Female caregivers reported worse mental health than males.
Study at a glance
| Characteristics | Multicentric observational study Peer reviewed |
|---|---|
| Sample size | 146 |
| Population | Patients in a vegetative state admitted to two long-term care facilities in Lombardy |
| Duration | Up to 15 years follow-up |
| Keywords | Death Disorder of consciousness Quality of life Vegetative state Caregiver burden |
| Key finding | Non-traumatic cerebral hemorrhage was the leading cause of vegetative state, and caregivers exhibited significant psychological distress, with female caregivers reporting worse mental health than males. |
Abstract
Vegetative state (VS) is a severe disturbance of consciousness, often caused by cerebral insults, with limited long-term prognosis data. to provide a detailed picture of a cohort of patients treated at 2 long-term care facilities in Lombardy starting from 2014. Multicentric observational study. Subjects who met the diagnostic criteria for VS were admitted. A caregiver was identified for each patient and filled two questionnaires to evaluate quality of life (SF-36) and need for psychological support (FSQ-30). The study included 146 patients (median age: 61.8 years at admission, 60.4 at the event that caused VS). Non-traumatic cerebral hemorrhage was the leading cause of VS (41%), followed by traumatic (19%) and anoxic brain injury (17%), and ischemic stroke (6.8%). The cumulative mortality was 10% at 1 year, 24% at 2 years, 43% at 5 years, 69% at 10 years, and 88% at 15 years after the event that caused VS, with age (HR 1.03) and ischemic stroke (HR 2.86) as risk factors. Among 24 caregivers, 50% had FSQ-30 score suggesting recommended psychological support (R area), 33% were in the SR area (strongly recommended), and 13% in the U area (urgent need). Females had worse FSQ-30 and SF-36 scores than males, particularly in the mental health index (median 60 vs. 74) and mental component scale (45.3 vs. 53.2). Hemorrhages were found to be the most common cause of VS, differing from previous studies that identified trauma as the primary cause. Caregivers exhibited significant psychological distress.