Rita Formisano1, Marta Aloisi2, Marco Iosa3, Marianna Contrada2,4, Federica Rizza2, Davide Sattin5, Matilde Leonardi5, Mariagrazia D'Ippolito2,6. 1. Post-Coma Unit, IRCCS Santa Lucia Foundation, Rome, Italy. r.formisano@hsantalucia.it. 2. Post-Coma Unit, IRCCS Santa Lucia Foundation, Rome, Italy. 3. Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy. 4. PhD Program in Behavioral Neuroscience, La Sapienza University of Rome, Rome, Italy. 5. Neurology, Public Health and Disability Unit, Scientific Department, Neurological Institute "Carlo Besta", IRCCS Foundation, Milan, Italy. 6. Department of Psychology, "La Sapienza" University of Rome, Rome, Italy.
Abstract
INTRODUCTION: The Brief Post-Coma Scale (BPCS) is an easy diagnostic tool for individuals with disorders of consciousness (DoC), in a reduced version from a previously Post-Coma Scale, that could distinguish patients in the minimally conscious state (MCS) from those in unresponsive wakefulness syndrome (UWS), formerly defined as vegetative state (VS). OBJECTIVE: Aim of the study was to assess the diagnostic validity of the BPCS in comparison with the Coma Recovery Scale-Revised (CRS-R), in its Italian validated version, the Disability Rating Scale (DRS), the Level of Cognitive Functioning (LCF), and the Glasgow Outcome Scale (GOS). METHODS: In an Italian multicenter study on 545 patients with DoC, 36 post-acute rehabilitation wards, 32 long-term care centers, and 2 family associations participated to data collection. RESULTS: Statistically significant correlations were found between the BPCS and the other clinical scales: R = 0.586 (p < 0.001) with LCF, R = - 0.566 (p < 0.001) with DRS, R = 0.622 (p < 0.001) with CRS-R. The BPCS scores resulted significantly correlated with the time from acute event (R = 0.117, p = 0.006). Patients with GOS score 2 had mean BPCS of 1.84 ± 1.19, whereas those with GOS 3 had significantly higher scores 3.88 ± 1.71 (p < 0.001). Similarly, in patients with vegetative state/UWS (VS/UWS), the mean BPSC score was 1.71 ± 1.09, significantly lower (p < 0.001) than that of patients with minimally conscious state (BPCS = 3.83 ± 1.29). Finally, the agreement of the BPCS and clinical diagnosis was of 84.4%, with an odds ratio OR = 3.781 (95% CI = 3.026-4.725, p < 0.001). CONCLUSIONS: The BPCS has demonstrated statistically significant correlations with the most commonly used scales in persons with DoC.
INTRODUCTION: The Brief Post-Coma Scale (BPCS) is an easy diagnostic tool for individuals with disorders of consciousness (DoC), in a reduced version from a previously Post-Coma Scale, that could distinguish patients in the minimally conscious state (MCS) from those in unresponsive wakefulness syndrome (UWS), formerly defined as vegetative state (VS). OBJECTIVE: Aim of the study was to assess the diagnostic validity of the BPCS in comparison with the Coma Recovery Scale-Revised (CRS-R), in its Italian validated version, the Disability Rating Scale (DRS), the Level of Cognitive Functioning (LCF), and the Glasgow Outcome Scale (GOS). METHODS: In an Italian multicenter study on 545 patients with DoC, 36 post-acute rehabilitation wards, 32 long-term care centers, and 2 family associations participated to data collection. RESULTS: Statistically significant correlations were found between the BPCS and the other clinical scales: R = 0.586 (p < 0.001) with LCF, R = - 0.566 (p < 0.001) with DRS, R = 0.622 (p < 0.001) with CRS-R. The BPCS scores resulted significantly correlated with the time from acute event (R = 0.117, p = 0.006). Patients with GOS score 2 had mean BPCS of 1.84 ± 1.19, whereas those with GOS 3 had significantly higher scores 3.88 ± 1.71 (p < 0.001). Similarly, in patients with vegetative state/UWS (VS/UWS), the mean BPSC score was 1.71 ± 1.09, significantly lower (p < 0.001) than that of patients with minimally conscious state (BPCS = 3.83 ± 1.29). Finally, the agreement of the BPCS and clinical diagnosis was of 84.4%, with an odds ratio OR = 3.781 (95% CI = 3.026-4.725, p < 0.001). CONCLUSIONS: The BPCS has demonstrated statistically significant correlations with the most commonly used scales in persons with DoC.
Entities:
Keywords:
Brief Post-Coma Scale; Coma Recovery Scale-Revised; Disorders of consciousness; Outcome evaluation scales
Authors: R Formisano; U Bivona; F Penta; M Giustini; M G Buzzi; P Ciurli; M Matteis; C Barba; C Della Vedova; V Vinicola; F Taggi Journal: Acta Neurochir Suppl Date: 2005