Brain-Injured Patients in Life Support May Survive 6 Months After Injury [Study]

It's difficult for family members to decide whether they should switch off the life support or still hope that their patient will survive. Researchers warned that many of those who died after life support was withdrawn could have lived.

Many Patients With Brain Injury Could Have Survived With Life Support

Recovery among patients with brain injury is unpredictable. Thus, family members are left with a difficult choice -- whether to switch off the life support or not.

William Sanders, a medical researcher at Boston's Massachusetts General Hospital, and associates analyzed the results of 212 patients who had suffered brain trauma in an attempt to comprehend the impossibility of what would have occurred to them had life support been maintained.

Their findings, which came from 18 trauma centers across the US, imply that some brain-injured patients may have lived for up to six months following the damage and may have even regained some degree of independence.

"Our findings support a more cautious approach to making early decisions on withdrawal of life support," said Yelena Bodien, a neurologist at Massachusetts General Hospital and senior author of the study.

Due to these complexities, physicians are advised not to make snap decisions about a patient's prognosis. The understanding of various types of consciousness in comatose individuals is still in its infancy. However, there are no established criteria or methods to assist clinicians in determining whether patients may have a meaningful recovery.

Nonetheless, once a person suffers serious brain damage, families are frequently requested to decide within 72 hours. It is believed that patients have little chance of survival or significant recovery if they do not recover quickly in the initial days.

Sanders and colleagues' analysis of the data ostensibly suggests otherwise.

The researchers developed a mathematical model to categorize patients based on their likelihood of having life support withdrawn, as well as their age, sex, medical history, injury characteristics, and clinical features, from a cohort of 1,392 patients with traumatic brain injuries admitted to intensive care units.

From there, Sanders and colleagues were able to match 132 individuals who had a similar health trajectory before and for a brief period following their brain injury but who did not have their life-sustaining treatment discontinued with 80 individuals who passed away after their life support was switched off.

This made it possible for the researchers to calculate the potential recovery levels for the 80 patients who passed away shortly after life support was turned off at three, six, and 12 months.

It remained uncertain what would have happened if the machines had continued to operate. Still, they drew tentative conclusions from follow-up data from people in a similar, agonizing situation.

According to the data, 45 percent of the 56 brain trauma patients who were kept on life support survived, although 31 of them passed away within six months. Over 30 percent of the 25 patients who made it through the six months recovered sufficiently to be at least somewhat independent in their daily routines.

Coma Patients With Hidden Consciousness Likely To Survive Brain Injury

Another study suggested that the curious phenomenon called "hidden consciousness," or cognitive motor dissociation (CMD) could determine a patient's survival. The condition was observed among coma patients who suffered from acute brain injury.

Jan Claassen, the study's author, critical care neurologist at New York-Presbyterian/Columbia University Irving Medical Center, and Columbia University researcher, stated that although patients with CMD are unable to follow verbal commands because their bodies do not respond, they can hear and understand.

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