Multidisciplinary attentive treatment for patients with chronic disorders of consciousness following severe traumatic brain injury in the NASVA of Japan. (6th December 2019)

• Record Type: Journal Article
• Authors: Shinoda, Jun; Nagamine, Yoshihide; Kobayashi, Shigeki; Odaki, Masaru; Oka, Nobuo; Kinugasa, Kazushi; Nakamura, Hirohiko; Ichida, Takafumi; Miyashita, Ritsuko; Shima, Hiroji; Hama, Takashi
• Is Part Of: Brain injury. Volume 33:Number 13/14(2019)
• Page Start: 1660
• Page End: 1670
• Publication Date: 2019-12-06
• Subjects: Chronic DOC -- severe TBI -- NASVA -- NASVA score -- multidisciplinary attentive treatment (MAT); Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2019.1667535
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Primary Objective : The aim of this study was to demonstrate the clinical outcomes of long-term multidisciplinary attentive treatment (MAT) in patients with chronic disorders of consciousness (DOC) due to severe traumatic brain injury (TBI) following automotive accidents. Research Design : Five hundred and ten patients (mean age: 40.4 years) were enrolled in this retrospective study. Methods and Procedures : Patients were provided MAT for one to several years in the eight medical facilities of the National Agency for Automotive Safety and Victims' Aid (NASVA) in Japan. Clinical status for consciousness, communication, and activities of daily living were evaluated using the NASVA grading system. Outcomes and results : Following MAT, NASVA scores at discharge were significantly improved compared to those at admission in every patient subgroup including sex, age, NASVA score, and association with/without hypoxic encephalopathy at admission. Younger age, shorter interval between injury and admission, and better neurocognitive function at admission were found to be significant and independent factors for a good prognosis. Conclusions : MAT can partially improve the cognitive and physical abilities of patients with chronic DOC. From the perspective of not only restoring a patient's daily life, but also reducing the caregiver's burden, this type of treatment program warrants more public attention.