Effect of post-intensive care syndrome on the diagnosis of chronic disorders of consciousness: a prospective single-center study

OBJECTIVE: To analyze the change in the level of consciousness using the Coma Recovery Scale-Revised (CRS-R) in correlation with the reduction of the post-intensive care syndrome (PIC-syndrome) in patients with chronic disorders of consciousness (CDC). MATERIAL AND METHODS: The study included 76 patients, 47 males and 29 females. In the Department of Early Medical Rehabilitation, the mean treatment duration was 13.3 bed-days. During this time, patients received an average rehabilitation load of 84 hours. RESULTS: On admission, the most common domain was Neuromuscular Disorders, detected in 73 of 76 patients. Critical illness polymyoneuropathy and ICU-acquired dysphagia were the most persistent until discharge. The most significant improvement was observed in the Autonomous-Metabolic domain, with complete elimination of disorders in 8 patients. Overall, the mean PIC-syndrome score decreased from severe (6.2) to moderate (4.2) after medical rehabilitation. Also, a linear regression analysis showed that each decrease in PIT syndrome by 1 point was associated with a mean of +0.78 points on the CRS-R scale. CONCLUSION: With partial regression of PIC-syndrome during rehabilitation treatment, a true level of consciousness in CDC patients was manifested by an increase in the CRS-R score.