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Related Experiment Videos

Evaluation of coma and vegetative states.

M Rappaport1, A M Dougherty, D L Kelting

  • 1University of California Brain Function Study Unit, Agnews Developmental Center, San Jose, CA 95134.

Archives of Physical Medicine and Rehabilitation
|July 1, 1992
PubMed
Summary

The Coma/Near-Coma (CNC) scale effectively identifies modest improvement in patients with severe brain injuries. This reliable tool aids in determining eligibility for continued rehabilitation care.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Assessment

Background:

  • Severe traumatic and non-traumatic brain injuries often result in low-level functioning, including vegetative and near-vegetative states.
  • Accurate assessment of minimal clinical changes in these patients is crucial for guiding treatment and rehabilitation decisions.

Purpose of the Study:

  • To introduce and evaluate the Coma/Near-Coma (CNC) scale for measuring subtle clinical changes in severely brain-injured patients.
  • To assess the reliability and validity of the CNC scale in a clinical setting.

Main Methods:

  • The Coma/Near-Coma (CNC) scale was administered to 20 patients with severe brain injuries over a 16-week period.
  • Interrater reliability was assessed, and validity was examined through correlations with brain-multimodality evoked potential abnormality scores and the Disability Rating Scale.

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Main Results:

  • The CNC scale identified 25% of patients who showed modest improvement over the 16-week follow-up.
  • High interrater reliability (r = .95) and supported validity were demonstrated.
  • The scale was found to be easily learned, quick, and cost-effective to administer.

Conclusions:

  • The Coma/Near-Coma (CNC) scale is a reliable and valid tool for assessing low-level functioning patients with severe brain injuries.
  • The scale assists healthcare staff in identifying patients likely to benefit from continued intensive rehabilitation, potentially preventing premature transfer to lower care settings.