[en] The Wessex Head Injury Matrix (WHIM) is an assessment tool designed for use during and immediately after coma. The aim of this study was (1) to test a French adaptation of the WHIM, (2) to compare the WHIM to the Glasgow Coma Scale (GCS) and its extension, the Glasgow-Liege Coma Scale (GLS), and (3) to confirm the sequence of emergence of behaviours. The three scales were used to assess 23 patients admitted to an intensive care unit with a GCS score equal to or less than 8 for at least 1 hour, longitudinally. Results indicated that the WHIM had good concurrent validity with the GCS and GLS, good inter-rater agreement, and excellent test-retest reliability. The WHIM is more appropriate and sensitive than the GCS and the GLS for the period of emerging from coma and immediately afterwards, whereas the GLS is more appropriate than the WHIM for the deepest phase of coma, as it also assesses brainstem reflexes. Furthermore, analysis of our data confirmed the ordering of the 66 items of the WHIM as a function of sequence of recovery from coma, as suggested by its authors.
Disciplines :
Neurosciences & behavior
Author, co-author :
Majerus, Steve ; Université de Liège - ULiège > Département de Psychologie > Département de Psychologie
Van der Linden, Martial ; Université de Liège - ULiège > Département de Psychologie > Département de Psychologie
Shiel, Agnes
Language :
English
Title :
Wessex Head Injury Matrix and Glasgow/Glasgow-Liege coma scale: A validation and comparison study
American Congress of Rehabilitation Medicine (1995). Recommendations for use of a uniform nomenclature pertinent to patients with severe alterations of consciousness. Archives of Physical Medicine and Rehabilitation, 76, 205-209.
American Neurological Association Committee on Ethical Affairs (1993). Persistent vegetative state: Report of the American Neurological Association Committee on Ethical Affairs. Annals of Neurology, 33 (4), 386-391.
Ansell, B.J. (1991). Slow-to-recover brain injured patients: Rationale for treatment. Journal of Speech and Hearing Research, 34, 1017-1022.
Ansell, B.J., & Keenan, J.E. (1989). The Western Neuro-Sensory Stimulation Profile: A tool for assessing slow-to-recover head injured patients. Archives of Physical Medicine and Rehabilitation, 70, 104-108.
Benzer, A., Mitterschiffthaler, G., Marosi, M., Luef, G., Pühringer, F., De La Renotiere, K., Lehner, H., & Schmutzhard, E. (1991). Prediction of non-survival after trauma: Innsbruck Coma Scale. Lancet, 338, 977-978.
Born, J.D. (1988). The Glasgow-Liège Scale: Prognostic value and evolution of motor responses and brain stem reflexes after severe head injury. Acta Neurochirurgica, 91, 1-11.
Cohen, J.A. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46.
Davis, A.L. (1991). The visual response evaluation: A pilot study of an evaluation tool for assessing visual responses in low-level brain-injured patients. Brain Injury, 5 (3), 315-320.
Duff, D.L., & Wells, D.L. (1997). Postcomatose unawareness/vegetative state following severe brain injury: A content methodology. Journal of Neuroscience Nursing, 29 (5), 305-317.
Fielding, K., & Rowley, G. (1990). Reliability of assessments by skilled observers using the Glasgow Coma Scale. Australian Journal of Advanced Nursing, 7 (4), 13-17.
Fleiss, J.L. (1971). Measuring nominal scale agreement among many raters. Psychological Bulletin, 76, 378-382.
Freeman, E.A. (1996). The Coma Exit Chart: Assessing the patient in prolonged coma and the vegetative state. Brain Injury, 10 (8), 615-624.
Giacino, J.T. (1997). Disorders of consciousness: Differential diagnosis and neuropathologic features. Seminars in Neurology, 17 (2), 105-111.
Hagen, C., Malkmus, D., & Durham, P. (1979). Levels of cognitive function, rehabilitation of head injured adults: Comprehensive physical management. Downey, CA: Profession Staff Association of Rancho Los Amigos Hospital Inc.
Harris, J.O., & Berger, J.R. (1991). Clinical approach to stupor and coma. In W.G. Bradley, R.B. Daroff, G.M. Fenichel, & C.D. Marrden (Eds.), Neurology in clinical practice. Principles of diagnosis and management (Vol 1). Stoneham, MA: Butterworth-Heinemann.
Horn, S., Shiel, A., McLellan, L., Campbell, M., Watson, M., & Wilson, B. (1993). A review of behavioural assessment scales for monitoring recovery in and after coma with pilot data on a new scale of visual awareness. Neuropsychological Rehabilitation, 3, 121-137.
Horn, S., Watson, M., Wilson, B.A., & McLellan, D.L. (1992). The development of new techniques in the assessment and monitoring of recovery from severe head injury: A preliminary report and case history. Brain Injury, 6 (4), 321-325.
International Working Party (1996). Report on the vegetative state. London: Royal Hospital for Neuro-Disability.
Jennett, B., & Teasdale, G., (1981). Management of Head Injuries. Philadelphia: F.A. Davis.
Kallert, T.W. (1994). Das "apallische Syndrom" - zu Notwendigkeit und Konsequenzen einer Begriffserklärung. Fortschritte der Neurologie-Psychiatrie, 62 (7), 241-255.
Moskopp, D., Stähle, C., & Wassermann, H.D. (1995). Problems of the Glasgow Coma Scale with early intubated patients. Neurosurgical Review, 18, 253-257.
Multi-Society Task Force on PVS (1994). Medical aspects of the persistent vegetative state. New England Journal of Medicine, 330, 1499-1508.
Ommaya, A.K. (1966). Trauma to the nervous system. Annals of the Royal College of Surgeons, England, 39, 317-347.
Ostrum, A.E. (1994). The "locked-in" syndrome - comments from a survivor. Brain Injury, 8, 95-98.
Prasad, K. (1996). The Glasgow Coma Scale: A critical appraisal of its clinimetric properties. Journal of Clinical Epidemiology, 49, 755-763.
Rader, M.A., & Ellis, D.W. (1994). The Sensory Stimulation Assessment Measure (SSAM): A tool for early evaluation of severely brain-injured patients. Brain Injury, 8, 309-321.
Rappaport, M., Dougherty, A.M., & Kelting, D.L. (1992). Evaluation of coma and vegetative states. Archives of Physical Medicine and Rehabilitation, 73, 628-634.
Rowley, G., & Fielding, K. (1991). Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. Lancet, 337, 535-538.
Shiel, A., Horn, S.A., Wilson, B.A., McLellan, D.L., Watson, M.J., & Campbell, M. (in press). The Wessex Head Injury Matrix main scale: A preliminary report on a scale to assess and monitor patients' recovery after severe head injury. Clinical Rehabilitation.
Stalhammar, D., Starmark, J.E., Holmgren, E., Eriksson, N., Nordstrom, C.-H., Fedders, O., & Rosanoler, B. (1988). Assessment of neurological responsiveness in acute cerebral disorders. Multicenter study on the Reaction Level Scale (RLS 85). Acta Neurochirurgica, 90, 73-80.
Stanczak, D.E., White, J.G. III, Gouvier, W.D., Moehle, K.A. Daniel, M., Novack, T., & Long, C.J. (1984). Assessment of level of consciousness following severe neurological insult: Comparison of psychometric qualities of Glasgow Coma Scale and Comprehensive Levels of Consciousness Scale. Journal of Neuro surgery, 60, 955-960.
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, ii, 81-84.
Teasdale, G., & Jennett, B. (1975). Acute impairment of brain function: 1. Assessing conscious level. Nursing Times, 71, 914-917.
Teasdale, G., & Jennett, B. (1976). Assessment and prognosis of coma after head injury. Acta Neurochirurgica, 34, 45-55.
Watson, M., & Horn, S. (1992). Paired preferences technique: An alternative method for investigating sequences of recovery in assessment scales. Clinical Rehabilitation, 6, 170.
Watson, M., Horn, S., Shiel, A., & McLellan, D.L. (1997). The application of a paired comparisons technique to identify sequence of recovery after severe head injury. Neuropsychological Rehabilitation, 7, 441-458.
Wilson, B.A., Shiel, A., Watson, M., Horn, S., & McLellan, L. (1994). Monitoring behaviour during coma and post traumatic amnesia. In B. Uzzell & A.-L. Christensen (Eds.), Progress in the rehabilitation of brain injured people. Hillsdale, NJ: Erlbaum.
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.