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Around a quarter of patients in an acute vegetative state when they are first admitted to hospital have a good chance of recovering making it extremely important to use caution when deciding to limit medical care.

New studies underline the importance of extreme caution in any decision to limit the life chances of patients during the acute phase of a vegetative state.

Around a quarter of patients in an acute vegetative state when they are first admitted to hospital have a good chance of recovering a significant proportion of their faculties, and up to a half will regain some level of consciousness, researchers from Belgium found out.

Another study shows that around 40% of patients were wrongly diagnosed as being in a vegetative state, when they in fact registered the awareness levels of minimal consciousness.

Comparing past studies on this issue shows that the level of misdiagnosis has not decreased in the last 15 years. These studies should foster debate about appropriate standards of care for these patients, and about end-of-life limitations, experts said at the European Neurological Society (ENS) meeting in Rhodes, Greece. A complementary study shows that assessment by medical teams of a patient’s actual state of consciousness continues to be surrounded by confusion and false diagnosis, experts reported at the ENS Meeting.

The type of injury to the brain is  also a decisive factor in recovery scenarios. Thus the study undertaken by the Belgian team also analyzed patients according to whether brain damage came from traumatic or non-traumatic injuries. People suffering traumatic brain injuries have a much better chance of some recovery. 70% of those with traumatic injuries were restored to some level of consciousness. People with non-traumatic injuries, such as oxygen deprivation, fared much worse. Only 36% in the study achieved comparable recovery. Likewise, mortality rates differed sharply between the two groups, with 19% of those suffering traumatic injuries dying in hospital, while 48% of patients with non-traumatic brain injuries died.

So far, no court worldwide has agreed that care should be withdrawn from patients classified as minimally conscious.