Former F1 Doctor: Michael Schumacher could be moved home but fans should be 'prepared for bad news'
Dr Hartstein's comments come after reports that the 45-year-old has lost 25pc of his body weight since his skiing accident three months ago at a French resort.
“As mentioned previously, the longer one remains in a vegetative state, the less the likelihood of emerging, and the higher the chances of severe ramifications if the patient does in fact emerge,” Dr Hartstein wrote on his blog.
“Most definitions consider the vegetative state to be permanent one year after the injury.
“Patients who are in a persistent/permanent vegetative state have lifespans that are measured in months to a few years. This depends on baseline function (extraordinary in the case of Michael, of course), the quality of nursing care, and other imponderables. They usually die of respiratory or urinary infections. Longer survivals have been described, but are exceptional.”
Mr Hartstein suggested Schumacher could be moved home to be with his family - if doctors were able to build an specially-catered intensive care unit - because the French hospital will at some point experience pressure on bed space.
He wrote: "I think it is inevitable that should the status quo continue, the ICU [intensive care unit] staff may well, at some point in the not-distant future, decide that the patient they’ve just been asked to admit has a higher need for that bed than Michael, given his clinical situation and prognosis.
"This then could be a reason to organise a transfer – to a private clinic, or to an ICU-like environment that his entourage could build at his home."
Hartstein, F1 sport's chief doctor between 2005 and 2012, does go on to say that Schumacher's fitness will be hugely beneficial, assuming he awakens from his non responsive state.
“To be blunt, a patient in coma doesn’t really NEED his or her muscles . . . with the exception of the diaphragm. The diaphragm, which like the heart is pretty much always active, resists atrophy rather better than other muscles, but it does atrophy," he wrote.
“And having a machine doing the breathing for you is one of the best ways to see how disuse atrophy affects the diaphragm too. Unfortunately, and assuming (as I have until now) that Michael is being ventilated by a respirator, there is probably some degree of diaphragmatic atrophy at this point.”
Hartstein defined his condition as a “persistent coma” with significant recovery challenges.
If a patient doesn’t regain consciousness within a year, most doctors consider the vegetative state permanent, he said.