Patients in prolonged DoC are at high risk to develop severe medical complications, such as seizures, respiratory and urinary tract infections, pressure sores, deep vein thrombosis, cardiac and endocrine-metabolic dysfunctions, as well as spasticity related complications. Well-established epidemiological data for medical and neurological complications and comorbidities as well as specific tools for their assessment are lacking. Consequently, there are currently no evidence-based guidelines for their management in this patient population. The lack of such guidelines is particularly significant in the post-acute phase of recovery, when rehabilitative and therapeutic personalized programs should be planned and implemented based on patient status and prognostic markers. Better characterization of the overall clinical complexity in such cases could optimize resource allocation for health-care systems and provide better understanding of clinical outcomes in persons with DoC.
Clinical Complexity of Patients with Prolonged DOC
Rita Formisano, Italy
The Comorbidities Coma Scale (CoCoS)
Francesca Pistoia, Italy
Medical and Neurological Complications and Comorbidities in Disorders of Consciousness
Craig DiTommaso, USA
Douglas Katz, USA