Objective:

To systematically characterize the 5-year natural history of prolonged disorders of consciousness (pDoC) and identify predictors of outcomes.

Approach:

• Study Design: Single-center, prospective cohort study involving 1,000 patients with pDoC (VS or MCS ≥ 28 days post-brain injury) at Guangdong Sanjiu Brain Hospital.
• Data Collection: Standardized clinical assessments, neuroimaging, and biomarkers collected at multiple time points over 5 years.
• Primary Outcomes: Consciousness recovery, all-cause mortality, and major cardiovascular events.
• Secondary Outcomes: Functional status changes, dynamic biomarker changes, health-related quality of life, and rehospitalization rate.
• Statistical Analysis: Time-to-event analyses using Fine-Gray competing-risk models and development of prognostic prediction models.

Key Findings:

• The study aims to provide long-term data on pDoC outcomes, which are currently scarce.
• It will incorporate competing-risk analysis to improve prognostic accuracy.
• The study seeks to validate a multimodal prognostic prediction model.

Interpretation:

Limitations:

• Single-center design may limit generalizability.
• Potential challenges in the implementation of advanced neuroimaging techniques.

Conclusion:

Sources:

• Clinical Trial Registration