TY - JOUR
T1 - Correlation between Glasgow coma score components and survival in patients with traumatic brain injury
AU - Kung, Woon Man
AU - Tsai, Shin Han
AU - Chiu, Wen Ta
AU - Hung, Kuo Sheng
AU - Wang, Shin Ping
AU - Lin, Jia Wei
AU - Lin, Muh Shi
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research and/or authorship of this article: National Health Research Institute, Taiwan (Grant No. NHRI-EX99-9707PI); Department of Health, Executive Yuan, Taiwan (Grant No. DOH99-TD-B-111-003).
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/9
Y1 - 2011/9
N2 - 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.
AB - 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.
KW - Eye
KW - Glasgow coma scale (GCS)
KW - Motor
KW - Survival prediction
KW - Traumatic brain injury (TBI)
KW - Verbal combinations
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U2 - 10.1016/j.injury.2010.09.019
DO - 10.1016/j.injury.2010.09.019
M3 - Article
C2 - 21067749
AN - SCOPUS:80052091231
SN - 0020-1383
VL - 42
SP - 940
EP - 944
JO - Injury
JF - Injury
IS - 9
ER -