Does a regular Wessex Head Injury Matrix assessment identify early signs of infections in people with Prolonged Disorders of Consciousness?

Dhamapurkar, Samira Kashinath; Wilson, Barbara A.; Rose, Anita; Florschutz, Gerhard; Watson, Peter; Shiel, Agnes

doi:10.1080/02699052.2018.1484165

Cited by 4 publications

(6 citation statements)

References 15 publications

(20 reference statements)

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“…Dhamapurkar and colleagues [ 56 ] reported that regular WHIM assessments might identify early signs of infections in PDOC patients. They correlated this scale scores with the pre-infection period and with post-infection and observed that the decrease in WHIM scores was related to the infection insurgence.…”

Section: Discussionmentioning

confidence: 99%

Behavioral scales variability in patients with prolonged disorders of consciousness

et al. 2023

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Background The principal conditions differentiating disorders of consciousness (DOC) patients are the unresponsive wakefulness syndrome/vegetative state (UWS/VS) and the minimally conscious state (MCS). Many individuals who suffer from sudden-onset severe brain injury move through stages of UWS/VS and MCS before regaining full awareness. In some patients, the DOC condition is protracted for years (PDOC). In this study, we observed PDOC patients for 6 months to assess possible changes in their level of consciousness. Methods We enrolled 40 PDOC patients, 23 UWS/VS and 17 MCS hosted in a dedicated unit for long-term brain injury care. The time from injury was 472 ± 533 days for UWS/VS and 1090 ± 1079 days for MCS. The Wessex Head Injury Matrix (WHIM), Coma Recovery Scale-R (CRS-R), and Nociception Coma Scale were administered monthly for 6 months. Results During the period of assessment, the percentage of UWS/VS shifted from 58 to 45%, while for the MCS, from 42 to 55%. A positive correlation was found for the UWS/VS patients between the months of observation with the CRS-R total score and WHIM total numbers of behaviors (TNB). In the UWS/VS group, the CRS-R auditive and visual subscales correlated positively with the observation time. During the whole period of observation, 8 patients had constant CRS-R total scores while the WHIM TNB changed in 7 of them. Conclusion Our findings demonstrated that the monthly assessment of PDOC by means of the CRS-R and WHIM was able to detect also subtle changes in consciousness level.

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Section: Discussionmentioning

confidence: 99%

Behavioral scales variability in patients with prolonged disorders of consciousness

et al. 2023

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“…Dhamapurkar, Wilson, Rose, and Florschutz (2015b) looked at patients with a DOC lasting 12 months or more to see if recovery was more likely for those who had sustained a TBI compared to those whose DOC resulted from other causes (mainly hypoxia). All patients (28 total) with a DOC admitted to a rehabilitation center over a 3-year period were assessed with the WHIM and the Disability Rating Scale (DRS; Hall, Hamilton, Gordon, & Zasler, 1993) to determine if they had emerged from a DOC.…”

Section: The Effect Of Modafinil On Level Of Consciousness: a Pilot S...mentioning

confidence: 99%

Assessment and treatment of people with a disorder of consciousness: An account of some recent studies.

Wilson¹,

Dhamapurkar²,

Rose³

2016

Psychology & Neuroscience

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This paper describes a number of studies looking at the assessment and treatment of people with disorders of consciousness (DOCs). These include patients in a coma, patients in a vegetative state (VS), and patients in a minimally conscious state (MCS). It is important to distinguish between these latter 2 states, as referral decisions may well be different for the 2 groups. A new version of a measure to assess patients with DOCs is described. The effects of posture on awareness are then considered. Provided that medical conditions do not contraindicate this, assessments should be carried out when the patient is in an upright position, as the majority of patients with DOCs show more behaviors when assessed on a tilt table or a standing frame. The third study looks at the effect of modafinil, an agent that maintains wakefulness and promotes attention and concentration, on levels of consciousness. Those with a traumatic brain injury (TBI) would appear to respond more to this than those whose DOC is caused by hypoxia. The fourth study compares the delayed recovery of 2 groups of patients, those with a TBI and those with hypoxic brain damage. Not surprisingly, those who showed delayed recovery of consciousness were far more likely to have sustained a TBI than hypoxic brain damage. The paper concludes with a case study of a man who had a DOC for 19 months before regaining consciousness and proceeding to regain skills so that he is now leading a reasonably normal life.

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“…Shiel [6] and Majerus [13] tested the inter-rater reliability (IRR) and test-retest reliability (TRR) of the WHIM on a group of 25 and 5 subjects, respectively. Other studies highlighted the potentiality of WHIM in assessing patients with prolonged DOC (PDOC) [14,15].…”

Section: Introductionmentioning

confidence: 99%

Wessex Head Injury Matrix in Patients with Prolonged Disorders of Consciousness: A Reliability Study

Cortese,

Arcuri,

Vatrano

et al. 2023

Biomedicines

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Introduction: The Wessex Head Injury Matrix (WHIM) was developed to assess patients with disorders of consciousness (DOC) and was tested in terms of inter-rater reliability (IRR) and test–retest reliability (TRR) in the year 2000. The American Congress of Rehabilitation and Medicine reported that IRR and TRR were unproven. We aim to assess the reliability of the WHIM in prolonged DOC patients (PDOC). Methods: A total of 51 PDOC patients (32 unresponsive wakefulness syndrome (UWS/VS) and 19 minimally conscious state (MCS)) who were hosted in a dedicated unit for long-term brain injury care were enrolled. The time from injury ranged from 182 to 3325 days. Two raters administered the Coma Recovery Scale-Revised (CRS-R) and the WHIM to test the IRR and TRR. The TRR was administered two weeks after the first assessment. Results: For the CRS-R, the agreement in IRR and TRR was perfect between the two raters. The agreement for the WHIM ranged from substantial to almost perfect for IRR and from fair to substantial for the TRR. Conclusions: The WHIM showed a strong IRR when administered by expert raters and strongly correlated with the CRS-R. This study provides further evidence of the psychometric qualities of the WHIM and the importance of its use in PDOC patients.

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Does a regular Wessex Head Injury Matrix assessment identify early signs of infections in people with Prolonged Disorders of Consciousness?

Abstract: The findings suggest the importance of serial WHIM assessments throughout the period of recovery, not only to measure cognitive changes but also to highlight underlying physical changes such as infections that will impact the response to rehabilitation and recovery.

Cited by 4 publications

References 15 publications

Behavioral scales variability in patients with prolonged disorders of consciousness

Behavioral scales variability in patients with prolonged disorders of consciousness

Assessment and treatment of people with a disorder of consciousness: An account of some recent studies.

Wessex Head Injury Matrix in Patients with Prolonged Disorders of Consciousness: A Reliability Study

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