Citation

Kung WM, Tsai SH, Chiu WT, Hung KS, Wang SP, Lin JW, Lin MS. Injury 2011; 42(9): 940-944.

Affiliation

Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan; Department of Neurosurgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.injury.2010.09.019

PMID

21067749

Abstract

BACKGROUND: The Glasgow coma scale (GCS) score is used in the initial evaluation of patients with traumatic brain injury (TBI); however, the determination of an accurate score is not possible in all clinical situations. Our aim is to determine if the individual components of the GCS score, or combinations of them, are useful in predicting mortality in patients with TBI. METHODS: The components of the GCS score and the receiver-operating characteristic (ROC) curves were analyzed from 27,625 cases of TBI in Taiwan. RESULTS: The relationship between the survival rate and certain eye (E), motor (M) and verbal (V) score combinations for GCS scores of 6, 11, 12 and 13 were statistically significant. The areas under ROC curve of E+V, M+V and M alone were 0.904, 0.903 and 0.900, respectively, representing the 3 most precise combinations for predicting mortality. The area under the ROC curve for the complete GCS score (E+M+V) was 0.885. Patients with lower E, M and V score respectively, and lower complete GCS scores had higher hazard of death than those with the highest scores. CONCLUSION: The results of this study indicate that the 3 fundamental elements comprising the Glasgow coma scale, E, M, and V individually, and in certain combinations are predictive of the survival of TBI patients. This observation is clinically useful when evaluating TBI patients in whom a complete GCS score cannot be obtained.

Language: en