Correlation between Glasgow coma score components and survival in patients with traumatic brain injury.
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.


CONCLUSIONS
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.
Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
Woon-Man
WM
Kung
Shin-Han
SH
Tsai
Wen-Ta
WT
Chiu
Kuo-Sheng
KS
Hung
Shin-Ping
SP
Wang
Jia-Wei
JW
Lin
Muh-Shi
MS
Lin
D000328:Adult; D001930:Brain Injuries / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology*; D004812:Epidemiologic Methods; D005133:Eye Movements / Q000502:physiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D013624:Taiwan / Q000453:epidemiology; D014705:Verbal Behavior / Q000502:physiology