Three-Year Survival Rate and Changes in the Level of Consciousness in Outpatients After Severe Brain Injuries; [Трёхгодичная выживаемость и динамика уровня сознания у пациентов с последствиями тяжёлых повреждений головного мозга на амбулаторном этапе]

Introduction. There is aworldwide lackofstatisticaldataabout the patients withchronic disorders ofconsciousness (DOC). InRussia, there are nosuchdataat all. Objective: to perform the first study in Russia to assess the survival rate and changes in the level of consciousness in outpatients withthe chronic DOCafter their hospital discharge as well as to identify the predictors of survival andimprovement in the level of consciousness. Materials and methods. All the participants (n = 142) underwent their treatment and rehabilitation in Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology from January 2016 to January 2020. We recorded the changes in patient's vital status and their level of consciousness at the endpoints of3, 6, 12, 24, and36months fromthe brain injury (bothfor hospital andoutpatient stages). We usedthe Kaplan–Meier methodto assess the survivalrate. We also used the logistic regression model to determine the correlation between the predictors of the survival and the improvement in the level of consciousness at baseline and36months after the injury. Results. The mortality rate in the study group 3 years after the brain injury was 86.6%. Regardless of the survival rate, the level of consciousness hadsignificantly improved (i.e., they regained communication) in 22.5%of patients within 3 years after the index event. The statistically significant final model of the regression analysis (for 142patients)showedthat younger age andhigher overallCRS-Rscore improvedthe survivalrate. The logistic regressionmodelusedtodetermine the predictors of the improvement in the level of consciousness among the survivors gave no significant results. Conclusions. Highmortality rate among the outpatients, whose levelofconsciousness hadimprovedat discharge, proves the ineffectiveness ofthe outpatient rehabilitation. Thus, we needto finda way to improve it. The authors hope that the data obtainedin this study will formthe basis of their research. © 2023 World Regional Studies. All rights reserved.