Citation

Fortune PM, Shann F. Pediatr. Crit. Care Med. 2010; 11(3): 339-342.

Affiliation

From Paediatric Care, Royal Manchester Children's Hospital, Manchester, UK; and Intensive Care, Royal Children's Hospital, Melbourne, Victoria, Australia.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/PCC.0b013e3181c014ab

PMID

19838138

Abstract

OBJECTIVES:: To evaluate how well the full Glasgow Coma Scale and the motor response, which is a subscore of the Glasgow Coma Scale, predict the outcome in children who have sustained a traumatic brain injury. The best scores in the first 24 hrs were used. DESIGN:: A retrospective observational study. SETTING:: A pediatric intensive care unit. PATIENTS:: Children admitted between January 1997 and December 1999. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Recovery with independent function (good outcome), or death, persistent coma, or dependent (bad outcome) at 6 months after the injury. Complete information was available for 130 patients. Both the full Glasgow Coma Scale and the motor response predicted outcome well: the area under the receiver operating characteristic plot was 0.88 (95% confidence interval, 0.82-0.95) for the full score and 0.89 (0.82-0.95) for the motor response. CONCLUSIONS:: Both the full Glasgow Coma Scale score and the motor response provide a useful indication of long-term outcome, although neither score is sufficiently accurate to be used to limit treatment. The full Glasgow Coma Scale does not have a linear relationship with mortality, and there is poor interobserver agreement. The motor response should be used in children in preference to the full Glasgow Coma Scale; the predictive power is equivalent to the full Glasgow Coma Scale, there is a linear relationship to mortality, and it is easier to collect accurately.

Language: en