Epidemiological Survey of Vegetative State Patients in the Tohoku District, Japan: Special Reference to the Follow-up Study after One Year

An epidemiological survey of vegetative state patients (VSP) was conducted in the Tohoku District, Japan from 1975 through 1977. In the survey of 1976, we collected data on 219 VSP and performed follow-up study on these cases during 1977. Of the total 219 VSP, 14 cases (6%) improved and recovered from the vegetative state, 80 cases (36.7%) died, 110 cases (50%) remained unchanged, and 11 cases (5%) were loss during follow-up. The recovery from VSP was higher in younger age patients (under 60) compared to older age patients (above 60). No difference in recovery rates were noted by the causes of brain damage. Of the 14 patients who recovered, 11 (80%) recovered from the vegetative state within 2 years from onset. Eight patients received various treatments, i.e. forceful intracarotid injection of own arterial blood (auto-blood pumping therapy), systemic administration of levodopa or amantazine, intrathecal injection of nicholine, etc., while the remaining 6 patients were not treated by such specific remedies. In reply to our questionnaire, none of our survey staff reported that any of these treatments were specifically effective in treating VSP. Forty of the 80 deceased cases (50%) died within 2 years, 25 cases (31%) lived more than 3 years, and 7 (8.6%) lived more than 5 years. Pulmonary infection, heart failure, and renal insufficiency were the most common causes of VSP deaths. The incidence rate of VSP during this year (1977) was 1.10 and the prevalence rate on December 31, 1977, was 2.21 person per 100, 000 population. The annual incidence rate of 1976 through 1977 was 0.85 person per 100, 000 population. Sufficient nursing care and financial aid for VSP and their families were emphasized as extremely important to prevent them from falling into familial collapse.