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J Neurol Neurosurg Psychiatry 76:1420-1424 doi:10.1136/jnnp.2004.058198
  • Paper

Prevalence and characteristics of patients in a vegetative state in Dutch nursing homes

  1. J C M Lavrijsen1,2,
  2. J S G van den Bosch1,
  3. R T C M Koopmans2,
  4. C van Weel3
  1. 1De Zorgboog, Bakel, the Netherlands
  2. 2Department of Nursing Home Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
  3. 3Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
  1. Correspondence to:
 J Lavrijsen
 Radboud University Nijmegen Medical Centre, PO Box 9101, (229 VPHG), 6500 HB Nijmegen, the Netherlands; j.lavrijsenvphg.umcn.nl
  • Received 10 November 2004
  • Accepted 6 February 2005
  • Revised 28 January 2005

Abstract

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.

Footnotes

  • Competing interests: none declared

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