A Russian validation study of the Coma Recovery Scale-Revised (CRS-R)

The aim of the study was to develop and validate a Russian adaptation of the Coma Recovery Scale-Revised (CRS-R).

We evaluated 58 patients with chronic disorders of consciousness (> 4 weeks post-injury, DOC) of various etiology and two patients in a locked-in state at different stages after coma. We tested sensitivity for changes over 1 week, reliability, 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).

We obtained good sensitivity for changes in neurological status over week (p < 0.0001) and good test-retest reliability (r = 0.997, p < 0.0001) of the CRS-R. Inter-rater reliability was good (κ = 0.99, p < 0.001). We showed high internal consistency (α = 0.87) of the scale and good criterion validity between other scales (r = 0.597 for GCS, and r = 0.900 for FOUR). CRS-R also demonstrated a higher sensitivity in differential diagnosis of DOC, as compared to GCS, and FOUR Score (p < 0.001).

The results show that the Russian version of the CRS-R is a valid and sensitive tool for the evaluation of patients with chronic DOC, which can be used for differential diagnosis and for recovery assessment.