Assessment of Level of Consciousness with Coma Recovery Scale among Patients with Traumatic Brain Injury

Abstract

Traumatic brain injury (TBI) is one of the major cause of fatality and disability in paediatric age groups

and young adults. TBI is usually termed to as the “silent epidemic” because the adverse effects from TBI,

such as changes affecting thought process, perception, language, or emotional process, may not be readily

apparent1. It was found that nearly 1.5 to 2 million persons are injured and 1 million directed to death every

year in India. The objectives are to categorise the patients with traumatic brain injury based on the level of

consciousness, to compare the domains of level of consciousness (LOC) of patients with TBI and to find out

the association between the LOC and selected variables among patients with TBI at Govt. Medical college

Hospital, Kottayam. A quantitatve non experimental approach was used for the study. A total of sixty patients

with TBI were selected for the study by purposive sampling technique. The data were collected using socio

personal-clinical data sheet and Coma Recovery Scale-Revised (CRS-R). The LOC of patients with TBI

was assessed with CRS-R. The assessment of level of consciousness was assessed again by using the same

scale on the sixth day to compare the domains of the LOC through the recovery process. The obtained data

were categorised, compared and analysed by using descriptive and inferential statistics. The results showed

that the majority of patients selected were minimally conscious and the mean scores of domains of level of

consciousness (auditory, visual, motor, verbal, communication and arousal) increased from day 1 to day 6

and there is a significant association between the LOC and pupillary reaction at the time of first assessment

(p<0.05).