Issue 5-99, 2020

Original article

https://doi.org/10.38025/2078-1962-2020-99-5-11-18

Routing of Patients with Acquired Brain Injury as a Tool for Collecting Epidemiological Data about Disorders of Consciousness

View article (Download PDF file)



Download XML file

1 ORCIDBelkin V.А., 2 ORCIDRyabinkina J.V., 3 ORCIDIvanova G.Е., 1 ORCIDBelkin А.А., 4 ORCIDBochkarev P.Yu., 5 ORCIDLeyderman I.N., 1 ORCIDPinchuk E.A., 1 ORCIDRudnick E.N.

1 Clinical Institute of the Brain, Berezovsky, Russian Federation
2 Research Center of Neurology, Moscow, Russian Federation
3 Pirogov Russian National Research Medical University, Moscow, Russian Federation
4 Sverdlovsk Regional Hospital, Yekaterinburg, Russian Federation
5 Almazov Medical Research Center, Saint-Petersburg, Russian Federation


ABSTRACT

Introduction. Disorders of consciousness (DOC) form one of the most underexplored sections of neurosciences. An epidemiology of DOC may be crucial to evaluate the extent of this problem. There were several attempts to collect such data in different countries all over the world, but all of them seem to be very discrete.

Aim. To compile information about patients of Sverdlovskaya Oblast in which acquired brain injury (ABI) resulted in DOC, find out their outcomes and evaluate the prevalence rate of these states in the population of the region.

Material and methods. 6507 patients with ABI were monitored by Regional Neurocritical Care Center in Sverdlovsk Regional Hospital №1 during 2019. 492 patients from this group then were assessed by neurorehabilitation physicians of the Clinical Institute of Brain (CIB) via telemedi-cine consultation; 122 of them were directed to CIB for in-patient stage of treatment, the main intention of which was an advanced diagnostic of the level of consciousness. Unresponsive wakefulness syndrome (UWS) was confirmed in 29 patients.

Results. After in-patient stage of treatment changes in the consciousness level were assessed by follow-up via telemedicine consultation. To the end of January 2020, it made possible to find out that 9 of 29 UWS patients regained the level of consciousness; thus, 20 patients remained unresponsive. Taking into account that population of Sverdlovskaya oblast numbers 4,3 million, prevalence rate of new UWS cases in region equaled 0,46/100 000.

Conclusion. Application of telemedicine consultation allows to enquire DOC patients’ outcomes regardless of the patient location. Implementation of telemedicine can be useful for collecting this data and further analysis of revealed trends.



KEYWORDS: brain injury, vegetative state, unresponsive wakefulness syndrome, disorders of consciousness, telemedicine

FOR CITATION: Belkin V.А., Ryabinkina J.V., Ivanova G.E., Belkin А.А., Bochkarev P. Yu., Leyderman I.N., Pinchuk E.A., Rudnick. E.N. Routing of Patients with Acquired Brain Injury as a tool for Collecting Epidemiological Data About Disorders of Consciousness. Bulletin of Rehabilitation Medicine. 2020; 5 (99): 11-18. https://doi.org/10.38025/2078-1962-2020-99-5-11-18


References:

  1. Steven Laureys, Gastone G. Celesia, Francois Cohadon, Jan Lavrijsen, Jose Leon-Carrion, Walter G. Sannita, Leon Sazbon, Erich Schmutzhard, Klaus R. von Wild, Adam Zeman, Giuliano Dolce & the European Task Force on Disorders of Consciousness. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Medicine. 2010; (8): 68. DOI:10.1186/1741-7015-8-68
  2. Jennett B., Plum F. Persistent vegetative state after brain damage. A syndrome in search of a name. Lancet. 1972; (1): 734-737. DOI:10.1016/s0140-6736 (72)90242-5
  3. The Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state. New England Journal of Medicine. 1994; (330): 1499-1508. DOI:10.1056/NEJM199406023302206
  4. Bodart O., Laureys S., Gosseries O. Coma and disorders of consciousness: scientific advances and practical considerations for clinicians. Seminars in Neurology. 2013; (33): 83-90. DOI:10.1055/s-0033-1348965
  5. Jennett B.TheVegetativeState:MedialFacts,EthicalAndLegalDilemmas.CambridgeUniversityPress:Cambridge.2002.D0I:10.1017/CB09780511545535
  6. Beaumont J. G., Kenealy P. M. Incidence and prevalence of the vegetative and minimally conscious state. Neuropsychological Rehabilitaion. 2005; (15): 184-189. DOI:10.1080/09602010443000489
  7. Giacino J. T., Ashwal S., Childs N., Cranford R., Jennett B., Katz D. I., Kelly J. P., Rosenberg J. H., Whyte J., Zafonte R. D., Zasler N. D. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002; (58): 349-353. DOI:10.1212/wnl.58.3.349
  8. Giacino J. T., Kalmar K. The vegetative state and minimally conscious states: a comparison of clinical features and functional outcome. The Journal of Head Trauma Rehabilitation. 1997; (12): 36-51. PMID:15671583
  9. Jennett B. Resource allocation for the severely brain damaged. Archives of Neurology. 1976; (33): 595-597.
  10. W. S. van Erp, J. C. M. Lavrijsen, F. A. van de Laar, P. E. Vos, S. Laureys, R. T.C. M. Koopmans. The vegetative state or unresponsive wakefulness syndrome: a systematic review of prevalence studies. European Journal of Neurology. 2014; (21): 1361- 1368. DOI:10.1111/ene.12483
  11. Lavrijsen J. C., van den Bosch J. S., Koopmans R. T., van Weel C. Prevalence and characteristics of patients in a vegetative state in Dutch nursing homes. Journal of Neurology, Neurosurgery and Psychiatry. 2005; (76): 1420-1424. DOI:10.1136/jnnp.2004.058198
  12. Pistarini C., Lispi L., Ceccolini C. Burden of the vegetative state in Italy. Brain Inj. Conference: 8th World Congress on Brain Injury of the International Brain Injury Association Washington, DC United States. Conference Start: 20100310 Conference End: 20100314. Conference Publication: (var.pag-ings). 2010; (24): 120-121.
  13. Kohnen R. F., Lavrijsen J. C., Bor J. H., Koopmans R. T. The prevalence and characteristics of patients with classic locked-in syndrome in Dutch nursing homes. Journal of Neurology. 2013; (260): 1527-1534. DOI:10.1007/s00415-012-6821-y
  14. Charles L. Sprung, Simon L. Cohen, Peter Sjokvist, Mario Baras, Hans-Henrik Bulow, Seppo Hovilehto, Didier Ledoux, Anne Lippert, Paulo Maia, Dermot Phelan, Wolfgang Schobersberger, Elisabet Wennberg, Tom Woodcock. End-of-life practices in European intensive care units: the Ethicus Study. Journal of the American Medical Association. 2003; (290): 790-797. DOI:10.1001/jama.290.6.790
  15. Health Council of The Netherlands: Committee on Vegetative State. Patients in a Vegetative State. Health Council of the Netherlands: The Hague. 1994.
  16. Sverdlovsk Region Ministry of Health Decree № 1530-p since 29.12.2012. - Available at the Government of Sverdlovsk Region webpage. http://sverd-lovsk-gov.ru/doc/99275 (link is actual 15.09.2020) (In Russ.).
  17. Belkin V. A. [ACRM Disorders of Consciousness Practice Guidelines Review]. Farmateka. 2019; (3):14-19. DOI:10.18565/pharmateca.2019.3.14-19 (In Russ.).
  18. Sverdlovsk Region Ministry of Health Decree № 1049-p since 22.07.2015. - Available at the official legal information portal of Sverdlovsk Region webpage. http://www.pravo.gov66.ru/7044/(link is actual 15.09.2020) (In Russ.).
  19. Elizaveta G. Iazeva, Liudmila A. Legostaeva, Alexey A. Zimin, Dmitry V. Sergeev, Maxim A. Domashenko, Vladislav Y. Samorukov, Dzhamilya G. Yusupova, Julia V. Ryabinkina, Natalia A. Suponeva, Michael A. Piradov, Yelena. G. Bodien & Joseph T. Giacino. A Russian validation study of the Coma Recovery Scale-Revised (CRS-R). Brain Injury. 2019; (33): 2, 218-225. DOI:10.1101/276881
  20. Suvorov A.Yu., Ivanova G. E., Belkin A. A., Stahovskaya L. V. Vertikalizaciya pacienta s riskom vozniknoveniya PIT-sindroma [Verticalization of patients with a risk of PIT syndrome]. Bulletin of Rehabilitation Medicine. 2015; 4 (68): 37-39 (In Russ).
  21. Belkin V. A., Pozdnyakov D. G., Belkin А. А. Diagnostika fenomena kognitivno-motornogo razobshcheniya u pacientov s hronicheskimi narusheni-yami soznaniya [Cognitive motor dissociation diagnosis in patients with chronic disorders of consciousness] Nevrologia, neyropsihiatria, psyhosoma-tika. 2019; (11): 46-51. DOI:10.14412/2074-2711-2019-3S-46-51 (In Russ).
  22. Reabilitaciya vintensivnoj terapii - REABIT:klinicheskie rekomendacii [Rehabilitation in Intensive Care - REABIT: Clinical Practice Guidelines]. Bulletin of Rehabilitation Medicine. 2015; 5 (69): 86-108 (In Russ).
  23. Belkin A. A., ShelyakinV. A., Trofimov I.M., Demin T. A., Medvedskaya D.R., Turkov S.B., Chadova E.A., Alasheev A.M., Badaev F.I., Pinchuk E.A., Safonova T.Yu. Variant realizacii pilotnogo proekta po organizacii medicinskoj reabilitacii v Sverdlovskoj oblasti [Case pilot project on the organization of medical rehabilitation in the Sverdlovsk Region]. Bulletin of Rehabilitation Medicine. 2016; 6 (76): 64-72 (In Russ).
  24. Ivanova G.E., Melnikova E.V., Shmonin A.A., Verbitskay E.V., Aronov D.M., Belkin A. A., Belyaev A.F., Bodrova R.A., Bubnova M.G., BuilovaT.V., Maltseva M.N., Mishina I.E., Nesterin K.V., Nikiforov V.V., Prokopenko S.V., Sarana A.M., Stakhovskaya L.V., Suvorov A.Yu., Khasanova D.R.,Tsykunov M.B., Shamalov N.A., Yashkov A.V.Pilotnyj proekt Razvitie sistemy medicinskoj reabilitacii v Rossijskoj Federacii: predvaritel'nye rezul'taty realizacii na pervom i vtorom etapah medicinskoj reabilitacii [Pilot project Development of the medical rehabilitation system in Russian Federation (dome): preliminary results of implementation in the first and second stages]. Bulletin of Rehabilitation Medicine. 2017; 2 (78): 10-15 (In Russ).
  25. Ivanova G.E., Melnikov E.V., Beliaev A.T., Bodrova R.A., BuilovaT.V., Maltseva M.N., Mishina I.E., Prokopenko S.V., Sarana A.M., Stahovskaya L.V., Ha-sanova D.R., Thsikunov M.B., Samalov N.A., Suvorov A.Yu., Shmonin А. А. Как organizovat' medicinskuyu reabilitaciyu? [How to organize medical rehabilitation?]. Bulletin of Rehabilitation Medicine. 2018; 2 (84): 2-12 (In Russ).



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©


This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.