Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy

Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li The Second Department of Rehabilitation, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Hongling Li, The Second Department of Rehabilitation, The Second Hospital of Hebei Medical...

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Main Authors: Zhao L, Li S, Liu Y, Di Z, Li H
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:Journal of Multidisciplinary Healthcare
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Online Access:https://www.dovepress.com/analysis-of-prognostic-risk-factors-in-children-with-disorders-of-cons-peer-reviewed-fulltext-article-JMDH
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author Zhao L
Li S
Liu Y
Di Z
Li H
author_facet Zhao L
Li S
Liu Y
Di Z
Li H
author_sort Zhao L
collection DOAJ
description Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li The Second Department of Rehabilitation, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Hongling Li, The Second Department of Rehabilitation, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang City, Hebei Province, 050000, People’s Republic of China, Tel +86-031166002999, Email honglingli97@126.comBackground and Objective: Disorders of consciousness (DOC) are serious neurological conditions in children, often caused by brain injury, infection, or hypoxia, with limited effective treatments. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive approach due to its potential to improve cerebral oxygenation and promote neural repair. However, the prognostic factors influencing treatment outcomes in pediatric DOC remain unclear. This study aimed to identify the risk factors for prognosis of children with DOC undergoing HBOT.Methods: A retrospective analysis was conducted on 255 children diagnosed with DOC who received HBOT at the Second Hospital of Hebei Medical University from January 2010 to January 2024. Clinical data, including demographic information, etiology, Glasgow Coma Scale (GCS) scores, Coma Recovery Scale-Revised (CRS-R), treatment timing, and comorbidities, were collected. According to the Glasgow Outcome Scale (GOS) score, the children were divided into poor prognosis group and good prognosis group. Logistic regression analysis was performed to identify independent risk factors for poor prognosis.Results: Age < 12 years (OR: 0.319, 95% CI: 0.113– 0.901), late timing of HBOT intervention (OR: 41.667, 95% CI: 2.122– 818.296), low HBOT frequency (OR: 0.092, 95% CI: 0.019– 0.441), low GCS score before HBOT (OR: 0.523, 95% CI: 0.362– 0.756), low CRS-R score before HBOT (OR: 0.419, 95% CI: 0.226– 0.780), and hypoxic-ischemic encephalopathy (OR: 4.885, 95% CI: 1.508– 15.826) were risk factors for poor prognosis in DOC children (P < 0.05). Low GCS score before treatment was an independent risk factor for poor prognosis in DOC children after traumatic brain injury (P < 0.05), low CRS-R score before treatment was an independent risk factor for poor prognosis in DOC children after encephalitis (P < 0.05), and late timing of HBOT, low HBOT frequency and low CRS-R score before HBOT were independent risk factors for poor prognosis in DOC children after hypoxic-ischemic encephalopathy (P < 0.05).Conclusion: This study highlights the clinical value of early HBOT intervention and baseline neurological status in predicting recovery in children with DOC. Identifying these risk factors can help optimize treatment decisions and improve long-term neurological outcomes.Keywords: hyperbaric oxygen, children, disorders of consciousness, prognosis, influencing factor
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spelling doaj-art-eca0acb8607f470593cf9b579ac02e292025-08-20T03:28:25ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902025-06-01Volume 18Issue 138033812104369Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen TherapyZhao L0Li S1Liu Y2Di Z3Li H4The Second Department of RehabilitationThe Second Department of RehabilitationThe Second Department of RehabilitationThe Second Department of RehabilitationThe Second Department of RehabilitationLong Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li The Second Department of Rehabilitation, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Hongling Li, The Second Department of Rehabilitation, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang City, Hebei Province, 050000, People’s Republic of China, Tel +86-031166002999, Email honglingli97@126.comBackground and Objective: Disorders of consciousness (DOC) are serious neurological conditions in children, often caused by brain injury, infection, or hypoxia, with limited effective treatments. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive approach due to its potential to improve cerebral oxygenation and promote neural repair. However, the prognostic factors influencing treatment outcomes in pediatric DOC remain unclear. This study aimed to identify the risk factors for prognosis of children with DOC undergoing HBOT.Methods: A retrospective analysis was conducted on 255 children diagnosed with DOC who received HBOT at the Second Hospital of Hebei Medical University from January 2010 to January 2024. Clinical data, including demographic information, etiology, Glasgow Coma Scale (GCS) scores, Coma Recovery Scale-Revised (CRS-R), treatment timing, and comorbidities, were collected. According to the Glasgow Outcome Scale (GOS) score, the children were divided into poor prognosis group and good prognosis group. Logistic regression analysis was performed to identify independent risk factors for poor prognosis.Results: Age < 12 years (OR: 0.319, 95% CI: 0.113– 0.901), late timing of HBOT intervention (OR: 41.667, 95% CI: 2.122– 818.296), low HBOT frequency (OR: 0.092, 95% CI: 0.019– 0.441), low GCS score before HBOT (OR: 0.523, 95% CI: 0.362– 0.756), low CRS-R score before HBOT (OR: 0.419, 95% CI: 0.226– 0.780), and hypoxic-ischemic encephalopathy (OR: 4.885, 95% CI: 1.508– 15.826) were risk factors for poor prognosis in DOC children (P < 0.05). Low GCS score before treatment was an independent risk factor for poor prognosis in DOC children after traumatic brain injury (P < 0.05), low CRS-R score before treatment was an independent risk factor for poor prognosis in DOC children after encephalitis (P < 0.05), and late timing of HBOT, low HBOT frequency and low CRS-R score before HBOT were independent risk factors for poor prognosis in DOC children after hypoxic-ischemic encephalopathy (P < 0.05).Conclusion: This study highlights the clinical value of early HBOT intervention and baseline neurological status in predicting recovery in children with DOC. Identifying these risk factors can help optimize treatment decisions and improve long-term neurological outcomes.Keywords: hyperbaric oxygen, children, disorders of consciousness, prognosis, influencing factorhttps://www.dovepress.com/analysis-of-prognostic-risk-factors-in-children-with-disorders-of-cons-peer-reviewed-fulltext-article-JMDHHyperbaric oxygenChildrenDisorders of consciousnessPrognosisInfluencing factor
spellingShingle Zhao L
Li S
Liu Y
Di Z
Li H
Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy
Journal of Multidisciplinary Healthcare
Hyperbaric oxygen
Children
Disorders of consciousness
Prognosis
Influencing factor
title Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy
title_full Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy
title_fullStr Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy
title_full_unstemmed Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy
title_short Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy
title_sort analysis of prognostic risk factors in children with disorders of consciousness undergoing hyperbaric oxygen therapy
topic Hyperbaric oxygen
Children
Disorders of consciousness
Prognosis
Influencing factor
url https://www.dovepress.com/analysis-of-prognostic-risk-factors-in-children-with-disorders-of-cons-peer-reviewed-fulltext-article-JMDH
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