@article{ref1,
title="Reliability of Glasgow Coma Score in pediatric trauma patients",
journal="Journal of pediatric surgery",
year="2018",
author="DiBrito, Sandra R. and Cerullo, Marcelo and Goldstein, Seth D. and Ziegfeld, Susan and Stewart, Dylan and Nasr, Isam W.",
volume="53",
number="9",
pages="1789-1794",
abstract="BACKGROUND: Discordant assessments of Glasgow Coma Score (GCS) following trauma can result in inappropriate triage. This study sought to determine the reliability of prehospital GCS compared to emergency department (ED) GCS. <br><br>METHODS: We conducted a retrospective review of traumas from 01/2000 to 12/2015 at a Level-1 pediatric trauma center. We evaluated reliability between field and ED GCS using Pearson's correlation. We ascertained the difference between prehospital and ED GCS (delta-GCS). Associations between patient characteristics and delta-GCS were modeled using Poisson and linear regression, adjusting for demographic and clinical covariates. <br><br>RESULTS: We identified 5306 patients. Pearson's correlation for GCS measurements was 0.57 for ages 0-3, and 0.67-0.77 for other age groups. Mean delta-GCS was highest for age<3years (0.95, SD=2.4). Poisson regression demonstrated that compared to children 0-3years, higher age was associated with lower delta-GCS (RR 0.65 95% CI 0.56-0.74). Linear regression showed that in those with a delta-GCS, more severe injury (higher ISS, worse ED disposition) and older age were associated with a negative change, signifying decline in score. <br><br>CONCLUSIONS: GCS is generally unreliable in pediatric trauma patients aged 0-3years, particularly the verbal score component. This may impact accuracy of triage priority for pediatric trauma patients. LEVEL OF EVIDENCE: III, Prognostic.<br><br>Copyright © 2018. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2017.12.027",
url="http://dx.doi.org/10.1016/j.jpedsurg.2017.12.027"
}