The persistent vegetative state: An analysis of clinical correlates and costs

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A review was compiled of 23 patients in the persistent vegetative state; a condition that developed while the patients were in an acute care hospital. Before the onset of the persistent vegetative state, eight patients had had dementia, 11 were functionally dependent, and seven had neurologic disorders that gradually led to the persistent vegetative state. For patients in the persistent vegetative state, three types of mechanical support-respirators, nasogastric or gastrotomy tubes, and intravenous lines-were utilized. All three were necessary in 43% of patients, two types in 52%, and one type in 4%. All patients in the persistent vegetative state required at least one type of mechanical assistance. Their course was complicated in all cases by incontinence, and in the majority, by decubiti, pneumonia, and urinary tract infection. Only one patient improved enough to be able to say a few words. These patients required active medical care and invasive procedures that were costly but futile. The hospital bills obtained for 13 patients averaged $170,000, and the length of stay for all patients averaged 197 days, the equivalent to a total number of bed-days of 12.5 bed-years. The poor outcomes, requirements for mechanical support, and frequency of complications-especially when neurologic impairments were present before the onset of the persistent vegetative state-should be considered when evaluating the cost in hospital bills and bed occupancy.

Original languageEnglish (US)
Pages (from-to)381-384
Number of pages4
JournalNew York state journal of medicine
Volume92
Issue number9
StatePublished - 1992

Fingerprint

Persistent Vegetative State
Costs and Cost Analysis
Bed Occupancy
Hospital Costs
Mechanical Ventilators
Nervous System Diseases
Urinary Tract Infections
Nervous System
Dementia
Length of Stay
Pneumonia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{01026a5d7a0c4db8a16420a6605d37f0,
title = "The persistent vegetative state: An analysis of clinical correlates and costs",
abstract = "A review was compiled of 23 patients in the persistent vegetative state; a condition that developed while the patients were in an acute care hospital. Before the onset of the persistent vegetative state, eight patients had had dementia, 11 were functionally dependent, and seven had neurologic disorders that gradually led to the persistent vegetative state. For patients in the persistent vegetative state, three types of mechanical support-respirators, nasogastric or gastrotomy tubes, and intravenous lines-were utilized. All three were necessary in 43{\%} of patients, two types in 52{\%}, and one type in 4{\%}. All patients in the persistent vegetative state required at least one type of mechanical assistance. Their course was complicated in all cases by incontinence, and in the majority, by decubiti, pneumonia, and urinary tract infection. Only one patient improved enough to be able to say a few words. These patients required active medical care and invasive procedures that were costly but futile. The hospital bills obtained for 13 patients averaged $170,000, and the length of stay for all patients averaged 197 days, the equivalent to a total number of bed-days of 12.5 bed-years. The poor outcomes, requirements for mechanical support, and frequency of complications-especially when neurologic impairments were present before the onset of the persistent vegetative state-should be considered when evaluating the cost in hospital bills and bed occupancy.",
author = "Kaufman, {David Myland} and Lipton, {Richard B.}",
year = "1992",
language = "English (US)",
volume = "92",
pages = "381--384",
journal = "New York state journal of medicine",
issn = "0028-7628",
number = "9",

}

TY - JOUR

T1 - The persistent vegetative state

T2 - An analysis of clinical correlates and costs

AU - Kaufman, David Myland

AU - Lipton, Richard B.

PY - 1992

Y1 - 1992

N2 - A review was compiled of 23 patients in the persistent vegetative state; a condition that developed while the patients were in an acute care hospital. Before the onset of the persistent vegetative state, eight patients had had dementia, 11 were functionally dependent, and seven had neurologic disorders that gradually led to the persistent vegetative state. For patients in the persistent vegetative state, three types of mechanical support-respirators, nasogastric or gastrotomy tubes, and intravenous lines-were utilized. All three were necessary in 43% of patients, two types in 52%, and one type in 4%. All patients in the persistent vegetative state required at least one type of mechanical assistance. Their course was complicated in all cases by incontinence, and in the majority, by decubiti, pneumonia, and urinary tract infection. Only one patient improved enough to be able to say a few words. These patients required active medical care and invasive procedures that were costly but futile. The hospital bills obtained for 13 patients averaged $170,000, and the length of stay for all patients averaged 197 days, the equivalent to a total number of bed-days of 12.5 bed-years. The poor outcomes, requirements for mechanical support, and frequency of complications-especially when neurologic impairments were present before the onset of the persistent vegetative state-should be considered when evaluating the cost in hospital bills and bed occupancy.

AB - A review was compiled of 23 patients in the persistent vegetative state; a condition that developed while the patients were in an acute care hospital. Before the onset of the persistent vegetative state, eight patients had had dementia, 11 were functionally dependent, and seven had neurologic disorders that gradually led to the persistent vegetative state. For patients in the persistent vegetative state, three types of mechanical support-respirators, nasogastric or gastrotomy tubes, and intravenous lines-were utilized. All three were necessary in 43% of patients, two types in 52%, and one type in 4%. All patients in the persistent vegetative state required at least one type of mechanical assistance. Their course was complicated in all cases by incontinence, and in the majority, by decubiti, pneumonia, and urinary tract infection. Only one patient improved enough to be able to say a few words. These patients required active medical care and invasive procedures that were costly but futile. The hospital bills obtained for 13 patients averaged $170,000, and the length of stay for all patients averaged 197 days, the equivalent to a total number of bed-days of 12.5 bed-years. The poor outcomes, requirements for mechanical support, and frequency of complications-especially when neurologic impairments were present before the onset of the persistent vegetative state-should be considered when evaluating the cost in hospital bills and bed occupancy.

UR - http://www.scopus.com/inward/record.url?scp=0027073181&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027073181&partnerID=8YFLogxK

M3 - Article

C2 - 1407797

AN - SCOPUS:0027073181

VL - 92

SP - 381

EP - 384

JO - New York state journal of medicine

JF - New York state journal of medicine

SN - 0028-7628

IS - 9

ER -