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Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation

Background: Disorders of consciousness (DoCs) include unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). Critical illness polyneuropathy and myopathy (CIPNM) is frequent in severe acquired brain injuries and impacts functional outcomes at discharge from the intensive rehabi...

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Autores principales: Hakiki, Bahia, Cecchi, Francesca, Pancani, Silvia, Romoli, Anna Maria, Draghi, Francesca, Scarpino, Maenia, Sterpu, Raisa, Mannini, Andrea, Macchi, Claudio, Grippo, Antonello
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870865/
https://www.ncbi.nlm.nih.gov/pubmed/35204606
http://dx.doi.org/10.3390/diagnostics12020516
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author Hakiki, Bahia
Cecchi, Francesca
Pancani, Silvia
Romoli, Anna Maria
Draghi, Francesca
Scarpino, Maenia
Sterpu, Raisa
Mannini, Andrea
Macchi, Claudio
Grippo, Antonello
author_facet Hakiki, Bahia
Cecchi, Francesca
Pancani, Silvia
Romoli, Anna Maria
Draghi, Francesca
Scarpino, Maenia
Sterpu, Raisa
Mannini, Andrea
Macchi, Claudio
Grippo, Antonello
author_sort Hakiki, Bahia
collection PubMed
description Background: Disorders of consciousness (DoCs) include unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). Critical illness polyneuropathy and myopathy (CIPNM) is frequent in severe acquired brain injuries and impacts functional outcomes at discharge from the intensive rehabilitation unit (IRU). We investigated the prevalence of CIPNM in DoCs and its relationship with the consciousness assessment. Methods: Patients with DoCs were retrospectively selected from the database including patients admitted to the IRU of the IRCCS Don Gnocchi Foundation, Florence, from August 2012 to May 2020. Electroneurography/electromyography was performed at admission. Consciousness was assessed using the Coma Recovery Scale-Revised (CRS-R) at admission and discharge. Patients transitioning from a lower consciousness state to a higher one were classified as improved responsiveness (IR). Results: A total of 177 patients were included (UWS: 81 (45.8%); MCS: 96 (54.2%); 78 (44.1%) women; 67 years (IQR: 20). At admission, 108 (61.0%) patients had CIPNM. At discharge, 117 (66.1%) patients presented an IR. In the multivariate analysis, CRS-R at admission (p = 0.006; OR: 1.462) and CIPNM (p = 0.039; OR: −1.252) remained significantly associated with IR only for the UWS patients. Conclusions: CIPNM is frequent in DoCs and needs to be considered during the clinical consciousness assessment, especially in patients with UWS.
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spelling pubmed-88708652022-02-25 Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation Hakiki, Bahia Cecchi, Francesca Pancani, Silvia Romoli, Anna Maria Draghi, Francesca Scarpino, Maenia Sterpu, Raisa Mannini, Andrea Macchi, Claudio Grippo, Antonello Diagnostics (Basel) Article Background: Disorders of consciousness (DoCs) include unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). Critical illness polyneuropathy and myopathy (CIPNM) is frequent in severe acquired brain injuries and impacts functional outcomes at discharge from the intensive rehabilitation unit (IRU). We investigated the prevalence of CIPNM in DoCs and its relationship with the consciousness assessment. Methods: Patients with DoCs were retrospectively selected from the database including patients admitted to the IRU of the IRCCS Don Gnocchi Foundation, Florence, from August 2012 to May 2020. Electroneurography/electromyography was performed at admission. Consciousness was assessed using the Coma Recovery Scale-Revised (CRS-R) at admission and discharge. Patients transitioning from a lower consciousness state to a higher one were classified as improved responsiveness (IR). Results: A total of 177 patients were included (UWS: 81 (45.8%); MCS: 96 (54.2%); 78 (44.1%) women; 67 years (IQR: 20). At admission, 108 (61.0%) patients had CIPNM. At discharge, 117 (66.1%) patients presented an IR. In the multivariate analysis, CRS-R at admission (p = 0.006; OR: 1.462) and CIPNM (p = 0.039; OR: −1.252) remained significantly associated with IR only for the UWS patients. Conclusions: CIPNM is frequent in DoCs and needs to be considered during the clinical consciousness assessment, especially in patients with UWS. MDPI 2022-02-17 /pmc/articles/PMC8870865/ /pubmed/35204606 http://dx.doi.org/10.3390/diagnostics12020516 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hakiki, Bahia
Cecchi, Francesca
Pancani, Silvia
Romoli, Anna Maria
Draghi, Francesca
Scarpino, Maenia
Sterpu, Raisa
Mannini, Andrea
Macchi, Claudio
Grippo, Antonello
Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation
title Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation
title_full Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation
title_fullStr Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation
title_full_unstemmed Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation
title_short Critical Illness Polyneuropathy and Myopathy and Clinical Detection of the Recovery of Consciousness in Severe Acquired Brain Injury Patients with Disorders of Consciousness after Rehabilitation
title_sort critical illness polyneuropathy and myopathy and clinical detection of the recovery of consciousness in severe acquired brain injury patients with disorders of consciousness after rehabilitation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870865/
https://www.ncbi.nlm.nih.gov/pubmed/35204606
http://dx.doi.org/10.3390/diagnostics12020516
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