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）作为评估脑损伤后意识障碍（Disorders of Consciousness, DoC）状态幼儿反应性工具的效用。我们从2023年9月前入组儿科住院脑损伤康复项目的患者医疗记录中回顾性提取了人口统计学资料及CRS-P数据，纳入标准为入组时年龄介于6个月至小于7岁，且住院期间至少接受过1次CRS-P评估。本研究最终纳入18例（<i>N</i> = 18）因新发脑损伤接受住院康复治疗的儿童，其年龄范围为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（<i>p</i> < 0.001）。CRS-P的听觉、视觉及运动子量表均能敏感捕捉入院至出院间的反应性变化（即反应性显著改善，<i>p</i>’s < 0.02）。略多于三分之一的患者（<i>n</i> = 7）从最低意识状态（Minimally Conscious State, MCS）中苏醒，且所有苏醒患者的首个觉醒征象均为功能性物品使用。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，CRS-P可用于分类评估重症脑损伤幼儿的意识障碍状态及觉醒转归情况。