title: Meta-analysis of Glasgow coma scale and simplified motor score in predicting traumatic brain injury outcomes.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis to compare the simplified motor score (SMS) and Glasgow Coma Scale (GCS) in predicting outcomes in patients with traumatic brain injury (TBI).
  
  
  METHODS
  Ovid EMBASE, Ovid Medline, Ovid PsycInfo, evidence-based medicine reviews and Scopus and related conference proceedings were searched through 28 February 2012 for studies comparing SMS and GCS in predicting the outcomes [emergency tracheal intubation (ETI), clinically significant brain injuries (CSBI), neurosurgical intervention (NSI) and mortality] in patients with TBI. A random-effects model was used for meta-analysis.
  
  
  RESULTS
  Five retrospective studies were eligible, enrolling a total of 102 132 subjects with TBI (63.4% males), with 14 670 (14.4%) ETI, 16 201 (15.9%) CSBI, 4730 (4.6%) NSI and 6725 (6.6%) mortality. Pooled AUC of the GCS and SMS were as follows: CSBI 0.79 and 0.75 (p = 0.16), NSI 0.83 and 0.81 (p = 0.34), ETI 0.85 and 0.82 (p = 0.31) and mortality 0.90 and 0.87 (p = 0.01). The difference in AUC for mortality was 0.03. Large heterogeneity between the studies was observed in all analyses (I(2 )> 50%).
  
  
  CONCLUSIONS
  In patients with TBI, SMS predicts different outcomes with similar accuracy as GCS except mortality. However, due to heterogeneity and limited numbers of studies, further prospective studies are required.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Balwinder
authors.initials: B
authors.lastname: Singh
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Prokop
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Erwin
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Mommer
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Mascarenhas
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Parsaik
mesh_terms: D019540:Area Under Curve; D001930:Brain Injuries / Q000401:mortality*; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D009043:Motor Activity; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D011379:Prognosis; D011597:Psychomotor Performance; D012372:ROC Curve