Glasgow scale relationships in pediatric and adult patients.
The purpose of this study was to examine the relationship of the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores in pediatric and adult patients having surgical entry into the cranium for diagnostic or therapeutic purposes after brain insult. In this retrospective record review, the predictor variable was the coma-associated GCS score (GCS score 3-8) obtained 24 hours after surgery. The outcome variable was the combined Glasgow Outcome category: recovery/moderate disability; severe disability/vegetative state; and death; ascertained 14 days postoperatively. Using discriminant analysis, the unweighted GCS scores for the total sample significantly discriminated two of the three GOS outcomes (p < .001); the weighted scores discriminated all three outcomes (p < .001). Considering the GCS components, the eye scores significantly discriminated one outcome, the motor scores two outcomes, and the verbal scores two outcomes (p < .001 to .005). The unweighted GCS scores in adults significantly discriminated all three outcomes and in children two outcomes; the weighted GCS scores in both children and adults significantly discriminated all three outcomes. The approximately 25% misclassification rate for outcomes, however, would preclude using the scales in a predictive or prescriptive manner.
Hofer
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Ohio Solid Organ Transplantation Consortium, Columbus 43221.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000451:nursing / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities / Q000145:classification*; D016002:Discriminant Analysis; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies