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Arch Phys Med Rehabil. 2013 Oct;94(10):1851-4. doi: 10.1016/j.apmr.2013.07.003. Epub 2013 Jul 13.

Disorders of consciousness: outcomes, comorbidities, and care needs.

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Moss Rehabilitation Research Institute, Elkins Park, PA. Electronic address:


Over the last decade, research on patients with disorders of consciousness (DOC) has suggested that their prognosis for functional recovery early after injury is surprisingly positive, particularly for those with traumatic etiologies; that meaningful recovery proceeds for longer intervals than previously appreciated; and that such individuals are often medically complex and challenging to manage. However, access to intensive specialty rehabilitation is limited for most individuals with DOC in the United States. The evolving understanding of DOC calls for a reconsideration of appropriate models of care. This collection of articles provides insight into the functional recovery of individuals with DOC, new tools for assessing prognosis, and the patterns of comorbidity that complicate the recovery process. In addition, models of care from the United States and Europe that attempt to address the needs of patients as well as their caregivers are presented.


Brain injuries; Consciousness disorders; DOC; Healthcare delivery; Minimally conscious state; Prognosis; Rehabilitation; Systems of care; Vegetative state; disorders of consciousness

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