Autor: |
Majerus Steve, Boly Melanie, Ventura Manfredi, Giacino Joseph, Vanhaudenhuyse Audrey, Schnakers Caroline, Moonen Gustave, Laureys Steven |
Jazyk: |
angličtina |
Rok vydání: |
2009 |
Předmět: |
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Zdroj: |
BMC Neurology, Vol 9, Iss 1, p 35 (2009) |
Druh dokumentu: |
article |
ISSN: |
1471-2377 |
DOI: |
10.1186/1471-2377-9-35 |
Popis: |
Abstract Background Previously published studies have reported that up to 43% of patients with disorders of consciousness are erroneously assigned a diagnosis of vegetative state (VS). However, no recent studies have investigated the accuracy of this grave clinical diagnosis. In this study, we compared consensus-based diagnoses of VS and MCS to those based on a well-established standardized neurobehavioral rating scale, the JFK Coma Recovery Scale-Revised (CRS-R). Methods We prospectively followed 103 patients (55 ± 19 years) with mixed etiologies and compared the clinical consensus diagnosis provided by the physician on the basis of the medical staff's daily observations to diagnoses derived from CRS-R assessments performed by research staff. All patients were assigned a diagnosis of 'VS', 'MCS' or 'uncertain diagnosis.' Results Of the 44 patients diagnosed with VS based on the clinical consensus of the medical team, 18 (41%) were found to be in MCS following standardized assessment with the CRS-R. In the 41 patients with a consensus diagnosis of MCS, 4 (10%) had emerged from MCS, according to the CRS-R. We also found that the majority of patients assigned an uncertain diagnosis by clinical consensus (89%) were in MCS based on CRS-R findings. Conclusion Despite the importance of diagnostic accuracy, the rate of misdiagnosis of VS has not substantially changed in the past 15 years. Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus. |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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