Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Neurocritical Care
Erschienen in: Neurocritical Care 1/2021

01.07.2021 | THE CURING COMA CAMPAIGN

Research Needs for Prognostic Modeling and Trajectory Analysis in Patients with Disorders of Consciousness

verfasst von: Flora M. Hammond, Sheryl Katta-Charles, Mary Beth Russell, Ross D. Zafonte, Jan Claassen, Amy K. Wagner, Louis Puybasset, Satoshi Egawa, Steven Laureys, Michael Diringer, Robert D. Stevens, the Curing Coma Campaign and its Contributing Members

Erschienen in: Neurocritical Care | Sonderheft 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

The current state of the science regarding the care and prognosis of patients with disorders of consciousness is limited. Scientific advances are needed to improve the accuracy, relevance, and approach to prognostication, thereby providing the foundation to develop meaningful and effective interventions.

Methods

To address this need, an interdisciplinary expert panel was created as part of the Coma Science Working Group of the Neurocritical Care Society Curing Coma Campaign.

Results

The panel performed a gap analysis which identified seven research needs for prognostic modeling and trajectory analysis (“recovery science”) in patients with disorders of consciousness: (1) to define the variables that predict outcomes; (2) to define meaningful intermediate outcomes at specific time points for different endotypes; (3) to describe recovery trajectories in the absence of limitations to care; (4) to harness big data and develop analytic methods to prognosticate more accurately; (5) to identify key elements and processes for communicating prognostic uncertainty over time; (6) to identify health care delivery models that facilitate recovery and recovery science; and (7) to advocate for changes in the health care delivery system needed to advance recovery science and implement already-known best practices.

Conclusion

This report summarizes the current research available to inform the proposed research needs, articulates key elements within each area, and discusses the goals and advances in recovery science and care anticipated by successfully addressing these needs.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Estraneo A, Moretta P, Loreto V, Lanzillo B, Santoro L, Trojano L. Late recovery after traumatic, anoxic, or hemorrhagic long-lasting vegetative state. Neurology. 2010;75:239–45.PubMed
2.
Nakase-Richardson R, Whyte J, Giacino JT, Pavawalla S, Barnett SD, Yablon SA, et al. Longitudinal outcome of patients with disordered consciousness in the NIDRR TBI Model Systems Programs. J Neurotrauma. 2012;29(1):59–65.PubMed
3.
Katz DI, Polyak M, Coughlan D, Nichols M, Roche A. Natural history of recovery from brain injury after prolonged disorders of consciousness: outcome of patients admitted to inpatient rehabilitation with 1–4 year follow-up. Prog Brain Res. 2009;177:73–88.PubMed
4.
Whyte J, Nakase-Richardson R, Hammond FM, McNamee S, Giacino JT, Kalmar K, et al. Functional outcomes in traumatic disorders of consciousness: 5-year outcomes from the National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems. Arch Phys Med Rehabil. 2013;94(10):1855–60.PubMed
5.
Hammond FM, Giacino JT, Nakase Richardson R, Sherer M, Zafonte RD, Whyte J, et al. Disorders of consciousness due to traumatic brain injury: functional status ten years post-injury. J Neurotrauma. 2019;36(7):1136–46.PubMed
6.
Giacino JT, Katz DI, Schiff ND, Whyte J, Ashman EJ, Ashwal S, et al. Practice guideline update recommendations summary: disorders of consciousness: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research. Neurology. 2018;91(10):450–60.PubMedPubMedCentral
7.
Turgeon AF, Lauzier F, Simard JF, Scales DC, Burns KE, Moore L, et al. Mortality associated with withdrawal of life-sustaining therapy for patients with severe traumatic brain injury: a Canadian multicentre cohort study. CMAJ. 2011;183(14):1581–8.PubMedPubMedCentral
8.
Turgeon AF, Lauzier F, Burns KE, Meade MO, Scales DC, Zarychanski R, et al. Determination of neurologic prognosis and clinical decision making in adult patients with severe traumatic brain injury: a survey of Canadian intensivists, neurosurgeons, and neurologists. Crit Care Med. 2013;41(4):1086–93.PubMed
9.
Kowalski RG, Hammond FM, Weintraub AH, Nakase-Richardson R, Zafonte RD, Whyte J, et al. Recovery of consciousness and functional outcome in moderate and severe traumatic brain injury. JAMA Neurol. 2021;78(5):548–57.PubMed
10.
Hammond F, Natarajan S, Toomer A, Huynh T, Norton J. Accuracy of predicting 6-month outcome at 48 hours following severe traumatic brain injury: a pilot study [abstract]. J Neurotrauma. 2009;26(8):A1-101.
11.
Izzy S, Compton R, Carandang R, Hall W, Muehlschlegel S. Self-fulfilling prophecies. NeuroCrit Care. 2013;19(3):347–63.PubMed
12.
Souter MJ, Blissitt PA, Blosser S, Bonomo J, Greer D, Jichici D, et al. Recommendations for the critical care management of devastating brain injury: prognostication, psychosocial, and ethical management : a position statement for healthcare professionals from the Neurocritical Care Society. Neurocrit Care. 2015;23(1):4–13.PubMed
13.
Truog R. New guidelines on severe brain injury complicate already difficult decisions. Boston Globe. 2019.
14.
Fins JJ. Disorders of consciousness and disordered care: families, caregivers, and narratives of necessity. Arch Phys Med Rehabil. 2013;94(10):1934–9.PubMed
15.
Lilley EJ, Scott JW, Weissman JS, Krasnova A, Salim A, Haider AH, Cooper Z. End-of-life care in older patients after serious or severe traumatic brain injury in low-mortality hospitals compared with all other hospitals. JAMA Surg. 2018;153(1):44–50.PubMed
16.
Rohaut B, Claassen J. Decision making in perceived devastating brain injury: a call to explore the impact of cognitive biases. Br J Anaesth. 2018;120(1):5–9.PubMed
17.
Edlow BL, Claassen J, Schiff ND, Greer DM. Recovery from disorders of consciousness: mechanisms, prognosis and emerging therapies. Nat Rev Neurol. 2021;17(3):135–56.PubMed
18.
O’Donnell JC, Browne KD, Kilbaugh TJ, Chen HI, Whyte J, Cullen DK. Challenges and demand for modeling disorders of consciousness following traumatic brain injury. Neurosci Biobehav Rev. 2019;98:336–46.PubMed
19.
Povlishock JT, editor; Brain Trauma Foundation; American Association of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care. Early indicators of prognosis in severe traumatic brain injury [Special section]. J Neurotrauma. 2000; 17(6–7):555–627.
20.
Geurts M, Macleod MR, van Thiel GJ, van Gijn J, Kappelle LJ, van der Worp HB. End-of-life decisions in patients with severe acute brain injury. Lancet Neurol. 2014;13(5):515–24.PubMed
21.
Giacino JT, Kalmar K. The vegetative and minimally conscious states: a comparison of clinical features and functional outcome. J Head Trauma Rehabil. 1997;12(4):36–51.
22.
Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S, et al. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol. 2009;9:35.PubMedPubMedCentral
23.
Childs NL, Mercer WN, Childs HW. Accuracy of diagnosis of persistent vegetative state. Neurology. 1993;43:1465–7.PubMed
24.
Andrews K, Murphy L, Munday R, Littlewood C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ. 1996;313:13–6.PubMedPubMedCentral
25.
Wannez S, Heine L, Thonnard M, Gosseries O, Laureys S; Coma Science Group collaborators. The repetition of behavioral assessments in diagnosis of disorders of consciousness. Ann Neurol. 2017;81(6):883–9.
26.
Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, et al. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002;58(3):349–53.PubMed
27.
Seel RT, Sherer M, Whyte J, Katz DI, Giacino JT, Rosenbaum AM, et al; American Congress of Rehabilitation Medicine; Brain Injury-Interdisciplinary Special Interest Group; Disorders of Consciousness Task Force. Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research. Arch Phys Med Rehabil. 2010;91(12):1795–813.
28.
Giacino JT, Schnakers C, Rodriguez-Moreno D, Kalmar K, Schiff N, Hirsch J. Behavioral assessment in patients with disorders of consciousness: gold standard or fool’s gold? Prog Brain Res. 2009;177:33–48.PubMed
29.
30.
Edlow BL, Fins JJ. Assessment of covert consciousness in the intensive care unit: clinical and ethical considerations. J Head Trauma Rehabil. 2018;33(6):424–34.PubMedPubMedCentral
31.
Wagner AK. TBI translational rehabilitation research in the 21st Century: exploring a Rehabilomics research model. Eur J Phys Rehabil Med. 2010;46(4):549–56.PubMed
32.
Giacino JT, Whyte J, Nakase-Richardson R, Katz DI, Arciniegas DB, Blum S, et al. Minimum competency recommendations for programs that provide rehabilitation services for persons with disorders of consciousness: a position statement of the American Congress of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research Traumatic Brain Injury Model Systems. Arch Phys Med Rehabil. 2020;101(6):1072–89.PubMed
33.
Yue JK, Vassar MJ, Lingsma HF, Cooper SR, Okonkwo DO, Valadka AB, et al. Transforming research and clinical knowledge in traumatic brain injury pilot: multicenter implementation of the common data elements for traumatic brain injury. J Neurotrauma. 2013;30(22):1831–44.PubMedPubMedCentral
34.
Dijkers MP, Marwitz JH, Harrison-Felix C. thirty years of national institute on disability, independent living, and rehabilitation research traumatic brain injury model systems center research-an update. J Head Trauma Rehabil. 2018;33(6):363–74.PubMedPubMedCentral
35.
36.
37.
38.
Bao Y, Bertoia ML, Lenart EB, Stampfer MJ, Willett WC, Speizer FE, et al. Origin, methods, and evolution of the three nurses’ health studies. Am J Public Health. 2016;106(9):1573–81.PubMedPubMedCentral
39.
Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999–1008.PubMed
40.
Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004;85(12):2020–9.PubMed
41.
Harris K, Linsenmeyer M, Weppner J, Breisinger T, Yukevich AM, Galang G, et al. Motor first: a proposed approach to the JFK Coma Recovery Scale-Revised for the consulting physician [abstract]. Am J Phys Med Rehabil. 2020;99 Suppl 3:a80.
42.
Kondziella D, Bender A, Diserens K, van Erp W, Estraneo A, Formisano R, et al. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness. Eur J Neurol. 2020;27(5):741–56.PubMed
43.
Velly L, Perlbarg V, Boulier T, Adam N, Delphine S, Luyt CE, et al. Use of brain diffusion tensor imaging for the prediction of long-term neurological outcomes in patients after cardiac arrest: a multicentre, international, prospective, observational, cohort study. Lancet Neurol. 2018;17(4):317–26.PubMed
44.
Comanducci A, Boly M, Claassen J, De Lucia M, Gibson RM, Juan E, et al. Clinical and advanced neurophysiology in the prognostic and diagnostic evaluation of disorders of consciousness: review of an IFCN-endorsed expert group. Clin Neurophysiol. 2020;131(11):2736–65.PubMed
45.
Olsen A, Babikian T, Bigler ED, Caeyenberghs K, Conde V, Dams-O’Connor K, et al. Toward a global and reproducible science for brain imaging in neurotrauma: the ENIGMA adult moderate/severe traumatic brain injury working group. Brain Imaging Behav. 2021;15(2):526–54.PubMed
46.
Claassen J, Doyle K, Matory A, Couch C, Burger KM, Velazquez A, et al. Detection of brain activation in unresponsive patients with acute brain injury. N Engl J Med. 2019;380(26):2497–505.PubMed
47.
Engemann DA, Raimondo F, King JR, Rohaut B, Louppe G, Faugeras F, et al. Robust EEG-based cross-site and cross-protocol classification of states of consciousness. Brain. 2018;141(11):3179–92.PubMed
48.
Laskowitz D, Grant G, editors. Translational research in traumatic brain injury. Boca Raton (FL): CRC Press/Taylor and Francis Group; 2016.
49.
Wagner AK. TBI Rehabilomics research: an exemplar of a biomarker-based approach to precision care for populations with disability. Curr Neurol Neurosci Rep. 2017;17(11):84.PubMed
50.
Wagner AK, Kumar RG. TBI Rehabilomics research: conceptualizing a humoral triad for designing effective rehabilitation interventions. Neuropharmacology. 2019;145(Pt B):133–44.PubMed
51.
Wagner AK. Rehabilomics: a conceptual framework to drive biologics research. PMR. 2011;3(6 Suppl 1):S28-30.
52.
Wagner AK, Zitelli KT. A Rehabilomics focused perspective on molecular mechanisms underlying neurological injury, complications, and recovery after severe TBI. Pathophysiology. 2013;20(1):39–48.PubMed
53.
Kumar RG, Wang Z, Kesinger MR, Newman M, Huynh TT, Niemeier JP, et al. Probabilistic matching of deidentified data from a trauma registry and a traumatic brain injury model system center: a follow-up validation study. Am J Phys Med Rehabil. 2018;97(4):236–41.PubMedPubMedCentral
54.
Kesinger MR, Kumar RG, Ritter AC, Sperry JL, Wagner AK. Probabilistic matching approach to link deidentified data from a trauma registry and a traumatic brain injury model system center. Am J Phys Med Rehabil. 2017;96(1):17–24.PubMedPubMedCentral
55.
Evans E, Gutman R, Shan M, Devone F, Kumar R, Resnik L, et al. Factors associated with successful discharge among older adults with traumatic brain injury in skilled nursing facilities. Arch Phys Med Rehabil. 2020;101(11):E12-13.
56.
Evans E, Gutman R, Davone F, Thomas K. Patient and injury characteristics of older adults with TBI receiving post-acute care in skilled nursing and inpatient rehabilitation facilities. Arch Phys Med Rehabil. 2020;101(11):E105.
57.
Corrigan JD, Bogner JA. Neighborhood characteristics and outcomes after traumatic brain injury. Arch Phys Med Rehabil. 2008;89(5):912–21.PubMed
58.
Corrigan JD, Bogner J, Pretz C, Mellick D, Kreider S, Whiteneck GG, et al. Use of neighborhood characteristics to improve prediction of psychosocial outcomes: a traumatic brain injury model systems investigation. Arch Phys Med Rehabil. 2012;93(8):1350-8.e2.PubMed
59.
60.
Leonardi M, Giovannetti AM, Pagani M, Raggi A, Sattin D; National Consortium Functioning and Disability in Vegetative and in Minimal Conscious State Patients. Burden and needs of 487 caregivers of patients in vegetative state and in minimally conscious state: results from a national study. Brain Inj. 2012;26(10):1201–10.
61.
Soeterik SM, Connolly S, Playford ED, Duport S, Riazi A. The psychological impact of prolonged disorders of consciousness on caregivers: a systematic review of quantitative studies. Clin Rehabil. 2017;31(10):1374–85.PubMed
62.
Steppacher I, Kissler J. A problem shared is a problem halved? Comparing burdens arising for family caregivers of patients with disorders of consciousness in institutionalized versus at home care. BMC Psychol. 2018;6(1):58.PubMedPubMedCentral
63.
Gonzalez-Lara LE, Munce S, Christian J, Owen AM, Weijer C, Webster F. The multiplicity of caregiving burden: a qualitative analysis of families with prolonged disorders of consciousness. Brain Inj. 2021;35(2):200–8.PubMed
64.
Wijdicks EF, Hijdra A, Young GB, Bassetti CL, Wiebe S; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;67(2):203–10.
Metadaten
Titel
Research Needs for Prognostic Modeling and Trajectory Analysis in Patients with Disorders of Consciousness
verfasst von
Flora M. Hammond
Sheryl Katta-Charles
Mary Beth Russell
Ross D. Zafonte
Jan Claassen
Amy K. Wagner
Louis Puybasset
Satoshi Egawa
Steven Laureys
Michael Diringer
Robert D. Stevens
the Curing Coma Campaign and its Contributing Members
Publikationsdatum
01.07.2021
Verlag
Springer US
Erschienen in
Neurocritical Care / Ausgabe Sonderheft 1/2021
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-021-01289-y

Weitere Artikel der Sonderheft 1/2021

Neurocritical Care 1/2021 Zur Ausgabe

The Curing Coma Campaign

Therapies to Restore Consciousness in Patients with Severe Brain Injuries: A Gap Analysis and Future Directions

The Curing Coma Campaign

Mechanisms Underlying Disorders of Consciousness: Bridging Gaps to Move Toward an Integrated Translational Science

The Curing Coma Campaign

Coma Science: The Territory and the Map

The CURING COMA CAMPAIGN

The Curing Coma Campaign: Challenging the Paradigm for Disorders of Consciousness

The Curing Coma Campaign

Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness

The Curing Coma Campaign

A Precision Medicine Framework for Classifying Patients with Disorders of Consciousness: Advanced Classification of Consciousness Endotypes (ACCESS)

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

29.05.2024 Hyponatriämie Nachrichten

Eine ältere Frau trinkt regelmäßig Sennesblättertee gegen ihre Verstopfung. Der scheint plötzlich gut zu wirken. Auf Durchfall und Erbrechen folgt allerdings eine Hyponatriämie. Nach deren Korrektur kommt es plötzlich zu progredienten Kognitions- und Verhaltensstörungen.

Schutz der Synapsen bei Alzheimer

29.05.2024 Morbus Alzheimer Nachrichten

Mit einem Neurotrophin-Rezeptor-Modulator lässt sich möglicherweise eine bestehende Alzheimerdemenz etwas abschwächen: Erste Phase-2-Daten deuten auf einen verbesserten Synapsenschutz.

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise