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 (opens in new tab)
Study at a glance
AI-extracted from the abstract| 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 Disorders of consciousness Long-term care outcomes Mental health impact |
| Key findings | 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.