Initial use of the Coma Recovery Scale for Pediatrics (CRS-P) in young children with disorders of consciousness

The utility of the Coma Recovery Scale for Pediatrics (CRS-P) was evaluated as a measure for assessing responsiveness in young children in states of disorders of consciousness (DoC) after brain injury. Retrospective demographic and CRS-P data were abstracted from medical records of patients between 6 months and &lt;7 years of age at admission to a paediatric inpatient brain injury rehabilitation program before September 2023 if administered the CRS-P at least once during admission. The sample included children aged 8 months to 6 years and 10 months (<i>N</i> = 18) admitted for inpatient rehabilitation following a new brain injury. CRS-P total score was significantly higher at discharge compared to admission (<i>p</i> &lt; .001). CRS-P auditory, visual, and motor subscales were sensitive to change (i.e. significant improvement in responsiveness) between admission and discharge (<i>p’s</i> &lt; 0.02). Just over one-third of patients (<i>n</i> = 7) emerged from a minimally conscious state (MCS), and functional object use was the first sign of emergence for all. Age at assessment was not significantly correlated with CRS-P scores. Conclusions: Results highlight the utility of the CRS-P for classifying states of DoC, as well as emergence, in young children with severe brain injury.

本研究评估了儿科昏迷恢复量表（Coma Recovery Scale for Pediatrics, CRS-P）在评估脑损伤后意识障碍（disorders of consciousness, DoC）状态幼儿反应性中的应用价值。本研究回顾性提取了2023年9月前入住儿科住院脑损伤康复项目的患者病历资料，纳入对象为入院时年龄介于6个月至未满7岁、且住院期间至少接受过1次CRS-P评估的患儿，提取内容包括人口统计学资料与CRS-P数据。最终纳入的样本为18例因新发脑损伤入住康复治疗的幼儿，其年龄介于8个月至6岁10个月。患儿出院时的CRS-P总分显著高于入院时（p<0.001）。CRS-P的听觉、视觉与运动子量表均对入院至出院期间的变化（即反应性的显著改善）具有敏感性（均p<0.02）。略多于三分之一的患者（n=7）从最小意识状态（minimally conscious state, MCS）中觉醒，且所有觉醒患者的首个觉醒征象均为功能性物体使用。评估时的年龄与CRS-P总分无显著相关性。结论：本研究结果证实了CRS-P在分类重度脑损伤幼儿的意识障碍状态及觉醒状态中的应用价值。