Abstract
Introduction: The aim of the present study was to validate a Russian adaptation of the Coma Recovery Scale–Revised (CRS-R).
Subjects and methods: We evaluated 58 patients diagnosed with chronic disorders of consciousness (>4 weeks post-injury, DOC) of various etiology and two patients in a locked-in state at different time points in their post-comatose recovery. We tested sensitivity for changes over 1 week, reliability, as well as criterion validity and diagnostic sensitivity of the Russian adaptation of the CRS-R in comparison with the Russian adaptations of Full Outline of UnResponsiveness Score (FOUR), and Glasgow Coma Scale (GCS).
Results: We obtained good sensitivity for changes in neurological status over one week (p<0.0001) and good test-retest reliability (r=1, p<0.0001) of the CRS-R. Inter-rater reliability for the CRS-R total score (κ=0.99, p<0.001) and subscale scores was good. We showed high internal consistency (α=0.87 and 0.89 for the first and second visit respectively). We also showed good criterion validity between two other standardized behavioral scales (moderate correlation with GCS, r=0.597 and high correlation with FOUR Score, r=0.900). CRS-R also demonstrated a significantly higher sensitivity in differential diagnosis of DOC, as compared to GCS, and FOUR Score (p<0.001).
Conclusion: The results show that the Russian version of the CRS-R is a valid and sensitive tool for the evaluation of severely brain damaged patients with chronic DOC which can be used for differential diagnosis and for the assessment of dynamic recovery.
Footnotes
lizaveta.mochalova{at}gmail.com
milalegostaeva{at}gmail.com
leha-zimin{at}inbox.ru
dmsergeev{at}yandex.ru
mdomashenko{at}gmail.com
dzhamilya-d{at}mail.ru
ryabinkina11{at}mail.ru
nasu2709{at}mail.ru
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jgiacino{at}mgh.harvard.edu