title: [Interobserver reliability of the Glasgow coma scale in critically ill patients with neurological and/or neurosurgical disease].
abstract: BACKGROUND
  The Glasgow coma scale (GCS) is a common tool used for neurological assessment of critically ill patients. Despite its widespread use, the GCS has some limitations, as sometimes different observers may value differently the same response.
  
  
  OBJECTIVE
  To evaluate the interobserver agreement, among intensive care nurses with a minimum of 3 years experience, both in the overall estimate of GCS and for each of its components.
  
  
  METHODS
  Prospective observational study including 110 neurological and/or neurosurgical patients conducted in a critical care unit of 18 beds, from October 2010 until December 2012. Registered variables: Demographic characteristics, reason for admission, overall GCS and its components. The neurological evaluation was conducted by a minimum of 3 nurses. One of them applied an algorithm and consensual assessment technique and all, independently, valued response to stimuli. Interobserver agreement was measured using the intraclass correlation coefficient (ICC) for a confidence interval (CI) of 95%. The study was approved by the Ethics Committee for Clinical Trails.
  
  
  RESULTS
  The intraclass correlation coefficient (confident interval) for scale was: Overall GCS: 0.989 (0.985-0.992); ocular response: 0.981 (0.974-0.986); verbal response: 0.971 (0.960-0.979); motor response: 0.987 (0.982-0.991).
  
  
  CONCLUSIONS
  In our cohort of patients we observed a high level of consistency in the application of both the GCS as in each of its components.
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.
authors.forename: M M
authors.initials: MM
authors.lastname: Sánchez-Sánchez
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Sánchez-Izquierdo
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.
authors.forename: E I
authors.initials: EI
authors.lastname: Sánchez-Muñoz
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Yegles
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.
authors.forename: M P
authors.initials: MP
authors.lastname: Fraile-Gamo
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España. Electronic address: susana.arias@salud.madrid.org.
authors.forename: S
authors.initials: S
authors.lastname: Arias-Rivera
mesh_terms: D000465:Algorithms; D064648:Critical Care Nursing / Q000706:statistics & numerical data*; D016638:Critical Illness; D005260:Female; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000601:surgery; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: Concordance; Concordancia; Enfermería; Escala del coma de Glasgow; Glasgow coma scale; Neurological patients; Nursing; Paciente neurológico