Validation of the Critical-Care Pain Observation Tool-Neuro in brain-injured adults in the intensive care unit: a prospective cohort study

摘要: Pain assessment in brain-injured patients the intensive care unit (ICU) is challenging and existing scales may not be representative of behavioral reactions expressed by this specific group. This study aimed to validate French-Canadian English revised versions Critical-Care Observation Tool (CPOT-Neuro) for ICU patients. A prospective cohort was conducted three Canadian one American sites. Patients with a traumatic or non-traumatic brain injury were assessed CPOT-Neuro trained raters (i.e., research staff nurses) before, during, after nociceptive procedures turning other) non-nociceptive non-invasive blood pressure, soft touch). who conscious delirium-free asked provide their self-report pain intensity (0–10). first data set completed all participants (n = 226), second (n = 87) obtained when change level consciousness (LOC) observed enrollment. Three LOC groups included: (a) unconscious (Glasgow Coma Scale GCS 4–8); (b) altered (GCS 9–12); (c) 13–15). Higher scores found during compared rest both sets (p   0.40 and > 0.60, respectively). cut-off scores ≥ 2 and ≥ 3 adequately classify mild severe self-reported pain ≥ 1 moderate pain ≥ 5, respectively. Interrater reliability raters’ supported intraclass correlation coefficients > 0.69. The valid multi-site sample at various LOC. Implementation studies are necessary evaluate tool’s performance clinical practice.