Recovery from prolonged disorders of consciousness: A dual-center prospective cohort study in China

Table 1 Characteristics of the patients

Characteristic	All (n = 93)	Group		P value
		VS/UWS (n = 62)	MCS (n = 31)
Age, yr, mean ± SD	49.8 ± 16.9	49.7 ± 16.4	50.1 ± 18.0	0.897
Maximum	85	80	85
Minimum	7	7	9
Sex, male, n (%)	69 (74.2)	42 (67.7)	27 (87.1)	0.044
Post injury days, median (Q25, Q75)	60 (35, 98)	59 (37, 95.5)	61 (32, 126)	0.446
Maximum	634	496	634
Minimum	28	28	28
Etiology, n (%)
Traumatic	35 (37.6)	25 (40.3)	10 (32.3)	0.368
Vascular	48 (51.6)	29 (46.8)	19 (61.3)
Anoxic	10 (10.8)	8 (2.9)	2 (6.5)
GCS score at admission, median (Q25, Q75)	8 (5.5, 9)	6 (4, 8)	10 (9, 11)	< 0.001
CRS-R score at admission, median (Q25, Q75)	5 (2, 9)	3 (1, 5)	10.5 (9, 13)	< 0.001
Outcome, n (%)
VS/UWS	35 (37.6)	35 (56.5)	0 (0.0)	< 0.001
MCS-	10 (10.8)	6 (9.7)	4 (12.9)
MCS+	1 (1.1)	1 (1.6)	0 (0.0)
EMCS	4 (4.3)	2 (3.2)	2 (6.5)
CS	29 (31.2)	11 (17.7)	18 (58.1)
LIS	7 (7.5)	1 (1.6)	6 (19.4)
Death	7 (7.5)	6 (9.7)	1 (3.2)
GOS outcome, n (%)
Death (1)	7 (7.5)	6 (9.7)	1 (3.2)	< 0.001
VS/UWS (2)	35 (37.6)	35 (56.5)	0 (0.0)
Severe disability (3)	24 (25.8)	11 (17.7)	13 (41.9)
Moderate disability (4)	16 (17.2)	5 (8.1)	11 (35.5)
Good (5)	11 (11.8)	5 (8.1)	6 (19.4)

VS/UWS: Vegetative state/unresponsive wakefulness syndrome; MCS: Minimally conscious state; EMCS: Emergence from minimally conscious state; LIS: Locked-in syndrome; CS: Conscious state; SD: Standard deviation; CRS-R: Coma recovery scale-revised; GCS: Glasgow coma scale; GOS: Glasgow outcome scale.

Table 2 Characteristics of patients with or without improved responsiveness

Characteristic	Outcome		P value
	Unawareness (n = 52)	Awareness (n = 41)
Age, yr, mean ± SD	49.4 ± 16.2	50.3 ± 17.8	0.797
Maximum	79	85
Minimum	7	13
Sex, male, n (%)	33 (63.5)	36 (87.8)	0.008
Days post injury, median (Q25, Q75)	65.5 (38.5, 136.5)	40.0 (30.0, 87.0)	0.006
Maximum	496	634
Minimum	29	28
Etiology, n (%)
Traumatic	23 (44.2)	12 (29.3)	0.007
Vascular	20 (38.5)	28 (68.3)
Anoxic	9 (17.3)	1 (2.4)
GCS score at admission, median (Q25, Q75)	6 (4, 8)	9 (7.5, 10)	< 0.001
CRS-R score at admission, median (Q25, Q75)	2.5 (1, 5)	9 (6, 12)	< 0.001
CRS-R score change at 1 mo, median (Q25, Q75)	5 (3, 7)	14 (10, 19)	< 0.001
CRS-R score change at 3 mo, median (Q25, Q75)	6 (4, 8)	20 (17, 22)	< 0.001
Diagnosis, n (%)
VS/UWS	47 (90.4)	15 (36.6)	< 0.001
MCS-	5 (9.6)	17 (41.5)
MCS+	0	9 (22.0)
GOS outcome, n (%)
Death (1)	6 (11.5)	1 (2.4)	< 0.001
VS/UWS (2)	35 (67.3)	0
Severe disability (3)	11 (21.2)	13 (31.7)
Moderate disability (4)	0	16 (39.0)
Good (5)	0	11 (26.8)

VS/UWS: Vegetative state/unresponsive wakefulness syndrome; MCS: Minimally conscious state; EMCS: Emergence from minimally conscious state; LIS: Locked-in syndrome; SD: Standard deviation; CRS-R: Coma recovery scale-revised; GCS: Glasgow coma scale; GOS: Glasgow outcome scale.

Table 3 Logistic regression analysis with recovery of awareness/unawareness as the outcome

	Univariable analysis		Multivariable analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Age	1.003 (0.979, 1.028)	0.794	1.004 (0.962, 1.048)	0.860
Sex	0.241 (0.081, 0.719)	0.011	0.949 (0.196, 4.600)	0.948
Days post injury	0.997 (0.992, 1.001)	0.172	0.985 (0.974, 0.996)	0.006
Group (VS/UWS vs MCS)	16.293 (5.317, 49.925)	< 0.001	0.083 (0.004, 1.701)	0.106
Etiology
Stroke vs TBI	2.683 (1.087, 6.623)	0.032	1.824 (0.410, 8.126)	0.430
HIE vs TBI	0.213 (0.024, 1.885)	0.165	0.006 (0.000, 4.798)	0.134
GCS score at admission	1.766 (1.370, 2.277)	< 0.001	0.312 (0.119, 0.823)	0.019
CRS-R score at admission	1.590 (1.322, 1.913)	< 0.001	4.822 (1.946, 11.949)	0.001

CI: Confidence interval; OR: Odds ratio; TBI: Traumatic brain injury; HIE: Hypoxic ischemic encephalopathy.