Study determined the degree of cognitive impairment, presence of clinical symptoms and functional disability at the time of emergence from the minimally conscious state (MCS) in patients with and without traumatic brain injury (TBI). Emergence from the MCS is associated with symptoms including disorientation, memory and attention impairment, restlessness, and significant functional disability. Participants were 169 adults (103 with TBI) who emerged from MCS based on the Coma Recovery Scale-Revised while in an inpatient Disorders of Consciousness program. Outcome measures included the Confusion Assessment Protocol (CAP) and Disability Rating Scale (DRS). CAP administration was attempted in 54 subjects. Twenty-eight subjects had valid scores on all CAP items, with a median of 4 symptoms of confusion. Scores in 93 percent of this subsample were consistent with an acute confusional state. The most common symptoms were cognitive impairment (98 percent of subjects), disorientation (93 percent), and agitation (69 percent). The median DRS score upon emergence from MCS was 14.5, indicating severe disability. Results indicate that emergence from the MCS is associated with an acute confusional state and severe disability. This finding may inform the lower boundary of confusion as well as approach to treatment and caregiver education.
Author(s):
Bodien, Yelena G. |Martens, Geraldine |Ostrow, Joseph |Sheau, Kristen |Joseph T. Giacino,|
