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We reviewed pre-admission diagnosis in all patients referred for inpatient brain injury neurorehabilitation over a 5-year period(n=193).All patients more than 1 month postinjury with diagnosis of coma or persistent vegetative state were selected for review(n=49).We found that 18(37%)of these patients were diagnosed inaccurately.Inaccurate diagnosis was more likely if the injury was more than 3 months before admission and the etiology of injury was trauma(48%).Results were statistically significant when traumatic injuries were compared with anoxic injuries(p<0.10).Errors in diagnosis may result from confusion in terminology,lack of extended observation of patients,and lack of skill or training in the assessment of neurologically devastated patients. |
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