The relationship between pre-hospital and emergency department Glasgow coma scale scores.
BACKGROUND
Pre-hospital GCS scores are used to make critical patient care decisions and to fill in gaps in hospital-based TBI surveillance, but they may not be accurate.


OBJECTIVE
To determine the relationship between pre-hospital (EMS-GCS) and emergency physician GCS scores (ED-GCS).


METHODS
Prospective observational study of 60 TBI patients with a field GCS of 8-13 and age > 18. ED-GCS, EMS-GCS, time of GCS and vitals signs were recorded.


METHODS
Simple and multiple linear regression.


RESULTS
The median EMS-GCS was 13 and that for ED-GCS was 15. There was a significant linear relationship between ED-GCS and EMS-GCS (r = 0.45, p = 0.003). There was improvement in the prediction of ED-GCS when alcohol/drug use and age (but not time) were added to EMS-GCS.


CONCLUSIONS
EMS-GCS is usually two points lower than ED-GCS, but the correlation between them is strong and independent of the time between score determinations. These results could prevent unnecessary procedures based on the EMS-GCS and improve the accuracy of TBI surveillance.
Bazarian
Jeffrey J
JJ
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. jeff_bazarian@urmc.rochester.edu
Eirich
Melissa A
MA
Salhanick
Steven D
SD
D000328:Adult; D000488:Allied Health Personnel; D000553:Ambulatory Care / Q000379:methods; D001930:Brain Injuries / Q000534:rehabilitation / Q000628:therapy*; D004630:Emergencies; D004632:Emergency Medical Services; D015600:Glasgow Coma Scale; D006801:Humans; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results