The Wessex Head Injury Matrix can be used to assess patients in various states of consciousness after suffering a severe head injury. Cognitive skills, cognitive. Clin Rehabil. Aug;14(4) The Wessex Head Injury Matrix (WHIM) main scale: a preliminary report on a scale to assess and monitor patient recovery. Wessex Head Injury Matrix (WHIM). – Shiel, Wilson, McLellan, Horn and Watson. (). – Cost for manual and scoring sheets. JFK Coma Recovery Scale –.
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Read the full text or download the PDF: Although there is still some overlap at the end of range, the revised order provides better separation of the four groups. Key information Assess and monitor recovery of cognitive function after severe head injury.
While relatively modest at a statistical level, this improvement may potentially mstrix in the clinical diagnosis for at least a proportion of cases. Supplemental Content Full text links. The unit serves a large supra-regional catchment area and, until very recently, there has been no contract in place to support longer term evaluation of PDOC status after patients leave the in-patient evaluation programme.
Medical aspects of the persistent vegetative state, part 1 and 2. Footnotes Contributors LT-S was responsible for the study design, clinical data collation and cleaning, analysis and interpretation.
A cohort analysis of prospectively collected serial WHIM data in consecutive patients admitted to a tertiary specialist neurorehabilitation unit in London, UK, for evaluation of PDOC during a year period between and Forgot your user name or password? Our pooled analysis of item frequency observed in all WHIM assessments, confirmed that the WHIM could potentially be used to categorise patients into the different PDOC subgroups, but that some reordering was required.
HR led the clinical WHIM data collection, contributed to the drafting, reviewing and revision of the manuscript and gave her final approval.
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Rehabilitation of the head injured adult: To develop a behavioural assessment based on observations of patients recovering after severe head injury whereby data could be collected by observation and by testing everyday hdad. The WHIM bridges the gap between tests available for the very martix stages after head injury and those helpful in later stages of recovery. Vegetative and minimally conscious states: On the negative side, analysis has had to take account of changes in the way data are recorded in routine practice, which has become more sophisticated and rigorous over time.
The mean time from onset to admission was Neuropsychol Rehabil ; Includes Manual and 25 Record Forms in a case. IV Confused — agitated: The tightly defined categories of observation contained in the WHIM overcome the limitations of previously published scales which, amongst hsad drawbacks, are largely dependent upon subjective views. Royal College of Physicians National Rehabilitation Hospital Fifty-eight items of behaviour were identified.
The frequency of observation for each item was collated and mapped matrox the RCP criteria and the item groupings proposed by Schnakers et al. The minimally conscious state: Log In More Log in via Institution.
Patients were included if they were admitted in either VS or MCS as a result of sudden-onset hexd brain injury any aetiologyand had at least three WHIM assessments.
Wessex Head Injury Matrix, The
It should also be noted that the classification of PDOC at the end of the assessment programme is not necessarily a hsad condition. Within this analysis we have concentrated on the order of items, rather than item redundancies. Assess and monitor recovery of cognitive function after severe head injury Qualification Level: Proposed reordering of WHIM items. Search for this keyword. It does not include long-term follow-up, so the eventual outcomes for this sample are unknown. Misdiagnosis of the vegetative state: Data are systematically collated from the patient clinical records in Microsoft Excel at the time of discharge.
The authors would like to thank all the staff and patients on the Regional Rehabilitation Unit at Northwick Park who contributed to the collection of data used in this analysis. In order to determine the extent to which outcome PDOC status at discharge could be predicted from baseline data, we examined the correlation with age, time since onset, length of observation period and admission WHIM ratings.
For some patients this can be a relatively quick transition, occurring over days or a few weeks. Generate a file for use with external citation management software.
These findings confirm that while the original WHIM hierarchical order was generally associated with the level of responsiveness, some items were out of order, so limiting its use as a diagnostic tool.
Reacting inconsistently and non-purposefully to stimuli. Following sudden-onset severe brain injury, many patients progress through stages of vegetative VS and minimally conscious state MCS as they emerge into a state of full awareness. In this service, the categorisation of PDOC status is assigned at discharge from the programme by consensus of the experienced MD clinical team, based on the findings from the full clinical evaluation, including any structured assessments that were undertaken.
It is easy and quick to administer by any qualified member of a multidisciplinary team. It focuses on what the patient does or does not do rather than upon clinical diagnostic features.
Methods The WHIM was administered serially by the multidisciplinary team throughout an in-patient evaluation programme mean length 74 sd42 days.