1. Prevalence and characteristics of patients in a vegetative state in Dutch nursing homes
- Author
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J S G van den Bosch, Raymond T.C.M. Koopmans, C van Weel, and Jan C. M. Lavrijsen
- Subjects
Adult ,Male ,Paper ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,media_common.quotation_subject ,Patient characteristics ,Sleep Disorders, Circadian Rhythm ,Effective Primary Care and Public Health [EBP 3] ,medicine ,Prevalence ,Humans ,Alzheimer Centre [NCEBP 11] ,Child ,Stroke ,media_common ,Aged ,Netherlands ,Coma ,Aged, 80 and over ,Heterogeneous group ,Cardiovascular diseases [NCEBP 14] ,Task force ,business.industry ,Convalescence ,Persistent Vegetative State ,Effective primary care and public health [NCEBP 7] ,Middle Aged ,medicine.disease ,Patient Discharge ,Nursing Homes ,Quality of Care [EBP 4] ,Psychiatry and Mental health ,Cross-Sectional Studies ,Family medicine ,Surgery ,Female ,Neurology (clinical) ,medicine.symptom ,Nursing homes ,business - Abstract
Contains fulltext : 47905.pdf (Publisher’s version ) (Closed access) OBJECTIVES: To establish the prevalence of vegetative state in Dutch nursing homes, describe the patient characteristics, and highlight the possible influence of medical decisions at the end of life. DESIGN: A cross-sectional survey. The vegetative state was defined according to the Multi Society Task Force on PVS. All Dutch nursing homes were approached to provide data on patients in a vegetative state. In cases of doubt, the researcher discussed the diagnosis with the patient's physician and, if necessary, examined the patient. Information on patients in a vegetative state in care between 2000 and September 2003 and end of life decisions for them were also recorded. RESULTS: All nursing homes and physicians participated. After assessment of 12 doubtful patients, 32 met the criteria of vegetative state lasting longer than one month, a prevalence of 2/1,000,000. Of these, 30 patients' data were analysed: age 9-90 years; 73% female; duration of vegetative state 2 months-20 years (26 surviving >1 year, 13 >5 years). Stroke was the commonest cause. Between 2000 and September 2003, there were 76 patients in a vegetative state in care of whom 34 died of complications and nine after withdrawal of artificial nutrition and hydration. CONCLUSIONS: The prevalence of vegetative state in Dutch nursing homes has been established for the first time. The figures are lower than suggested in the literature. The study included a heterogeneous group of patients, of which a substantial number survived for many years. The results cannot be explained by a policy of systematically withdrawing artificial nutrition and hydration.
- Published
- 2005