Reference : The nociception coma scale: A new tool to assess nociception in disorders of consciousne...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
Human health sciences : Neurology
http://hdl.handle.net/2268/67836
The nociception coma scale: A new tool to assess nociception in disorders of consciousness.
English
Schnakers, Caroline mailto [Université de Liège - ULg > > Centre de recherches du cyclotron >]
Chatelle, Camille mailto [Université de Liège - ULg > > Centre de recherches du cyclotron >]
Vanhaudenhuyse, Audrey mailto [Université de Liège - ULg > > Centre de recherches du cyclotron >]
Majerus, Steve mailto [Université de Liège - ULg > Département des sciences cognitives > Psychopathologie cognitive >]
Ledoux, Didier mailto [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
Boly, Mélanie mailto [Université de Liège - ULg > Département des sciences cliniques > Neurologie >]
Bruno, Marie-Aurélie [ > > ]
Boveroux, Pierre mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Demertzi, Athina [Université de Liège - ULg > > Centre de recherches du cyclotron >]
Moonen, Gustave mailto [Centre Hospitalier Universitaire de Liège - CHU > > Neurologie Sart Tilman >]
Laureys, Steven mailto [Centre Hospitalier Universitaire de Liège - CHU > > Neurologie Sart Tilman >]
2010
Pain
Elsevier Science
148
215-219
Yes (verified by ORBi)
International
0304-3959
1872-6623
Amsterdam
The Netherlands
[en] Nociception ; Behavioral assessment ; Brain Injury ; Consciousness ; Vegetative state ; Minimally conscious state
[en] Assessing behavioral responses to nociception is difficult in severely brain-injured patients recovering from coma. We here propose a new scale developed for assessing nociception in vegetative (VS) and minimally conscious (MCS) coma survivors, the Nociception Coma Scale (NCS), and explore its concurrent validity, inter-rater agreement and sensitivity. Concurrent validity was assessed by analyzing behavioral responses of 48 post-comatose patients to a noxious stimulation (pressure applied to the fingernail) (28 VS and 20 MCS; age range 20-82years; 17 of traumatic etiology). Patients' were assessed using the NCS and four other scales employed in non-communicative patients: the 'Neonatal Infant Pain Scale' (NIPS) and the 'Faces, Legs, Activity, Cry, Consolability' (FLACC) used in newborns; and the 'Pain Assessment In Advanced Dementia Scale' (PAINAD) and the 'Checklist of Non-verbal Pain Indicators' (CNPI) used in dementia. For the establishment of inter-rater agreement, fifteen patients were concurrently assessed by two examiners. Concurrent validity, assessed by Spearman rank order correlations between the NCS and the four other validated scales, was good. Cohen's kappa analyses revealed a good to excellent inter-rater agreement for the NCS total and subscore measures, indicating that the scale yields reproducible findings across examiners. Finally, a significant difference between NCS total scores was observed as a function of diagnosis (i.e., VS or MCS). The NCS constitutes a sensitive clinical tool for assessing nociception in severely brain-injured patients. This scale constitutes the first step to a better management of patients recovering from coma.
http://hdl.handle.net/2268/67836
10.1016/j.pain.2009.09.028

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