International survey on diagnostic and prognostic procedures in pediatric disorders of consciousness. (21st March 2019)

• Record Type: Journal Article
• Authors: Molteni, Erika; Slomine, Beth S.; Castelli, Enrico; Zasler, Nathan; Schnakers, Caroline; Estraneo, Anna
• Is Part Of: Brain injury. Volume 33:Number 4(2019)
• Page Start: 517
• Page End: 528
• Publication Date: 2019-03-21
• Subjects: Disorders of consciousness -- pediatric population -- severe brain injury -- diagnosis -- prognosis -- medical practice survey -- questionnaire; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2019.1565899
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Aims : 1. to investigate diagnostic and prognostic procedures routinely used by international professionals to assess children with disorders of consciousness (DoC); 2. to explore use and availability of internal and national guidelines for pediatric DoC; 3. to identify international differences in diagnostic/prognostic protocols. Methods : The International Brain Injury Association DoC Special Interest Group emailed a survey link to 43, 469 professionals. The survey included questions on diagnostic/prognostic procedures and guidelines for children with DoC. Results : Data on 82 respondents [(50% physicians) primarily from Europe (43.9%)and North America (37.8%)] were analyzed. Common diagnostic tools included the Glasgow Coma Scale for clinical assessment (94%), the Coma Recovery Scale-Revised for outcome measurement (57%), and cerebral MRI (94%). Clinical features used most frequently to inform prognosis varied with patient age. Few respondents used national (28%) admission protocols for children with DoC, and most were unaware of published national guidelines for diagnostic (72%) and prognostic (85%) procedures. Compared to North American respondents, more European respondents were physicians and used neurophysiological data for prognosis. Conclusions : This international survey provides useful information about diagnostic and prognostic procedures currently used for children with DoC and highlights the need for guidelines to promote best practices for diagnosis/prognosis in pediatric DoC.