Prevalence and characteristics of patients in a vegetative state in Dutch nursing homes
- 1De Zorgboog, Bakel, the Netherlands
- 2Department of Nursing Home Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- 3Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- Correspondence to: J Lavrijsen Radboud University Nijmegen Medical Centre, PO Box 9101, (229 VPHG), 6500 HB Nijmegen, the Netherlands;
- Received 10 November 2004
- Accepted 6 February 2005
- Revised 28 January 2005
Objectives: To establish the prevalence of vegetative state in Dutch nursing homes, describe the patient characteristics, and highlight the possible influence of medical decisions at the end of life.
Design: A cross-sectional survey. The vegetative state was defined according to the Multi Society Task Force on PVS. All Dutch nursing homes were approached to provide data on patients in a vegetative state. In cases of doubt, the researcher discussed the diagnosis with the patient’s physician and, if necessary, examined the patient. Information on patients in a vegetative state in care between 2000 and September 2003 and end of life decisions for them were also recorded.
Results: All nursing homes and physicians participated. After assessment of 12 doubtful patients, 32 met the criteria of vegetative state lasting longer than one month, a prevalence of 2/1 000 000. Of these, 30 patients’ data were analysed: age 9–90 years; 73% female; duration of vegetative state 2 months–20 years (26 surviving >1 year, 13 >5 years). Stroke was the commonest cause. Between 2000 and September 2003, there were 76 patients in a vegetative state in care of whom 34 died of complications and nine after withdrawal of artificial nutrition and hydration.
Conclusions: The prevalence of vegetative state in Dutch nursing homes has been established for the first time. The figures are lower than suggested in the literature. The study included a heterogeneous group of patients, of which a substantial number survived for many years. The results cannot be explained by a policy of systematically withdrawing artificial nutrition and hydration.
Competing interests: none declared