OTCohortBrain injury2018

Does a regular Wessex Head Injury Matrix assessment identify early signs of infections in people with Prolonged Disorders of Consciousness?

Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose and 3 others

PMID 29894208

WHAT IT FOUND

In people with prolonged disorders of consciousness, WHIM behavioural scores often dropped when infection was present.

It happened in 17 of 21 retrospective and 15 of 22 prospective patients, but vegetative-state scores may not change.

Key findings

01WHIM total score decreased with infection in 17 of 21 retrospective patients.

02WHIM total score decreased with infection in 15 of 22 prospective patients.

03Patients in a minimally conscious state showed a bigger proportion of WHIM change than patients in a vegetative state.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study included only 21 retrospective and 22 prospective patients. Patients in a vegetative state may have WHIM scores that are too low to show meaningful change, because four retrospective infection cases and six prospective patients showed no score change. The study was observational, so it reports an association between WHIM score drops and infection, not proof that a drop caused infection. All patients were in a specialist PDOC rehabilitation setting with devices, usual neurorehabilitation, medication and nursing care, so the findings may not apply to other settings.

Declared interests

The authors report no conflicts of interest.

The easy way to misread this

Do not treat a lower WHIM score as proof of infection. Four of the 21 retrospective infection cases showed no score change, and six prospective patients showed no change.

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