Prediction of poor outcome in anoxic-ischemic coma

Most patients who are comatose a few hours after a period of global cerebra l ischemia have a poor prognosis. in a series of studies selected with stri ct criteria for study design, the median prevalence of death or survival in a vegetative state was 78% (range, 56-90%) (Zandbergen et al., 1998). Most nonsurvivors die within the first weeks, not from brain damage, but from c ardiac or pulmonary complications. Uncertainty about treatment and nontreat ment decisions Fs therefore most critical during this period. To reduce thi s uncertainty among caregivers, and the related anxiety among family member s, early identification of patients with such a poor prognosis is desirable .