The persistent vegetative state

BMJ 1995;310:1137 (29 April)

Letters

The persistent vegetative state

Task force's definition influences interpretation of outcome

EDITOR,--Robin S Howard and David H Miller's comments on thestudy by the American Multi-Society Task Force on the persistentvegetative state leaves two aspects of the prognosis that needto be clarified.¹ The adult mortality of 82% at three yearsand 95% at five years might suggest that more prolonged survivalin a vegetative state is uncommon. Yet it is the prospect oflong survival that promotes the debate about continuing treatment.The task force, however, defined a persistent vegetative stateas being in a vegetative state at only one month after an acutecerebral insult; this would include some patients who had beenvegetative for only a few days after a period in coma. Manysuch patients die in the next few months and some recover, leavingonly 59%, 37%, and 24% of those vegetative at one month stillalive and . . . [Full text of this article]