Factors influencing recovery in a pediatric sample with disorders of consciousness: insights from an observational study

ABSTRACT

Objective

To estimate rates and time to reach emergence of consciousness from vegetative state/unresponsive wakefulness syndrome (VS/UWS), and explore factors associated with improved recovery in children and adolescents with disorders of consciousness (DoC) following severe traumatic and non-traumatic brain injury.

Methods

Analytical, retrospective, cohort study. Clinical records of consecutively referred patients admitted in VS/UWS to a neurological rehabilitation institute in Argentina, between 2005 and 2021 were reviewed. Seventy children and adolescents were included in the analysis. A specialized 12-week rehabilitation program was administered, and emergence was defined by scores ≥44 points on the Western Neuro Sensory Stimulation Profile (WNSSP), sustained for at least 3 weeks on consecutive weekly evaluations.

Results

Emergence from VS/UWS to consciousness occurred within 5.4 (SD 2.6) weeks in almost one-third of patients. Multivariate Cox regression analysis showed emergence was significantly lower in patients with hypoxic ischemic encephalopathy compared to patients with other non-traumatic etiologies [HRadj 0.23 (95% CI 0.06–0.89); p = 0.03)].

Conclusions

Our findings reinforce growing evidence on the impact of etiology on DoC recovery in pediatric populations, ultimately influencing treatment and family-related decisions in child neurorehabilitation.

KEYWORDS:

• Disorders of consciousness
• outcome
• pediatrics
• neurological rehabilitation
• neuropsychology

Acknowledgments

The authors would like to thank Fernando Salierno and Malen D. Moyano for their comments and help. They would also like to thank Ma. Flavia Dorrego, for encouraging them to carry out this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All authors contributed to the conception and design of this study. The first manuscript was written by MCG, FL, LDV, MA, and MF, and all commented and reformulated on subsequent versions. They also read and approved the final version of the manuscript.

Data availability statement

Data used in the analysis of this manuscript can be made available to interested parties through data requests submitted to the corresponding author.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2372451

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.