BACKGROUND: The Glasgow Coma Scale (GCS), which is the foundation of the Trauma Score, Trauma and Injury Severity Score, and the Acute Physiology and Chronic Health Evaluation scoring systems, requires a verbal response. In some series, up to 50% of injured patients must be excluded from analysis because of lack of a verbal component for the GCS. The present study extends previous work evaluating derivation of the verbal score from the eye and motor components of the GCS. METHODS: Data were obtained from a state trauma registry for 24,565 unintubated patients. The eye and motor scores were used in a previously published regression model to predict the verbal score: Derived Verbal Score = -0.3756 + Motor Score * (0.5713) + Eye Score * (0.4233). The correlation of the actual and derived verbal and GCS scales were assessed. In addition the ability of the actual and derived GCS to predict patient survival in a logistic regression model were analyzed using the PC SAS system for statistical analysis. The predictive power of the actual and the predicted GCS were compared using the area under the receiver operator characteristic curve and Hosmer-Lemeshow goodness-of-fit testing. RESULTS: A total of 24,085 patients were available for analysis. The mean actual verbal score was 4.4 +/- 1.3 versus a predicted verbal score of 4.3 +/- 1.2 (r = 0.90, p = 0.0001). The actual GCS was 13.6 + 3.5 versus a predicted GCS of 13.7 +/- 3.4 (r = 0.97, p = 0.0001). The results of the comparison of the prediction of survival in patients based on the actual GCS and the derived GCS show that the mean actual GCS was 13.5 + 3.5 versus 13.7 + 3.4 in the regression predicted model. The area under the receiver operator characteristic curve for predicting survival of the two values was similar at 0.868 for the actual GCS compared with 0.850 for the predicted GCS. CONCLUSIONS: The previously derived method of calculating the verbal score from the eye and motor scores is an excellent predictor of the actual verbal score. Furthermore, the derived GCS performed better than the actual GCS by several measures. The present study confirms previous work that a very accurate GCS can be derived in the absence of the verbal component.
BACKGROUND: The Glasgow Coma Scale (GCS), which is the foundation of the Trauma Score, Trauma and Injury Severity Score, and the Acute Physiology and Chronic Health Evaluation scoring systems, requires a verbal response. In some series, up to 50% of injured patients must be excluded from analysis because of lack of a verbal component for the GCS. The present study extends previous work evaluating derivation of the verbal score from the eye and motor components of the GCS. METHODS: Data were obtained from a state trauma registry for 24,565 unintubated patients. The eye and motor scores were used in a previously published regression model to predict the verbal score: Derived Verbal Score = -0.3756 + Motor Score * (0.5713) + Eye Score * (0.4233). The correlation of the actual and derived verbal and GCS scales were assessed. In addition the ability of the actual and derived GCS to predict patient survival in a logistic regression model were analyzed using the PC SAS system for statistical analysis. The predictive power of the actual and the predicted GCS were compared using the area under the receiver operator characteristic curve and Hosmer-Lemeshow goodness-of-fit testing. RESULTS: A total of 24,085 patients were available for analysis. The mean actual verbal score was 4.4 +/- 1.3 versus a predicted verbal score of 4.3 +/- 1.2 (r = 0.90, p = 0.0001). The actual GCS was 13.6 + 3.5 versus a predicted GCS of 13.7 +/- 3.4 (r = 0.97, p = 0.0001). The results of the comparison of the prediction of survival in patients based on the actual GCS and the derived GCS show that the mean actual GCS was 13.5 + 3.5 versus 13.7 + 3.4 in the regression predicted model. The area under the receiver operator characteristic curve for predicting survival of the two values was similar at 0.868 for the actual GCS compared with 0.850 for the predicted GCS. CONCLUSIONS: The previously derived method of calculating the verbal score from the eye and motor scores is an excellent predictor of the actual verbal score. Furthermore, the derived GCS performed better than the actual GCS by several measures. The present study confirms previous work that a very accurate GCS can be derived in the absence of the verbal component.
Authors: Jonathan Elmer; Daniel J Pallin; Shan Liu; Catherine Pearson; Yuchiao Chang; Carlos A Camargo; Steven M Greenberg; Jonathan Rosand; Joshua N Goldstein Journal: Neurocrit Care Date: 2012-12 Impact factor: 3.210
Authors: Kristina E Rudd; Christopher W Seymour; Adam R Aluisio; Marc E Augustin; Danstan S Bagenda; Abi Beane; Jean Claude Byiringiro; Chung-Chou H Chang; L Nathalie Colas; Nicholas P J Day; A Pubudu De Silva; Arjen M Dondorp; Martin W Dünser; M Abul Faiz; Donald S Grant; Rashan Haniffa; Nguyen Van Hao; Jason N Kennedy; Adam C Levine; Direk Limmathurotsakul; Sanjib Mohanty; François Nosten; Alfred Papali; Andrew J Patterson; John S Schieffelin; Jeffrey G Shaffer; Duong Bich Thuy; C Louise Thwaites; Olivier Urayeneza; Nicholas J White; T Eoin West; Derek C Angus Journal: JAMA Date: 2018-06-05 Impact factor: 56.272
Authors: Surender Khurana; Supriya Ravichandran; Megan Hahn; Elizabeth M Coyle; Spencer W Stonier; Samantha E Zak; Jason Kindrachuk; Richard T Davey; John M Dye; Daniel S Chertow Journal: Cell Host Microbe Date: 2020-02-12 Impact factor: 21.023
Authors: U K Bodanapally; K Shanmuganathan; Y P Gunjan; G Schwartzbauer; R Kondaveti; T R Feiter Journal: AJNR Am J Neuroradiol Date: 2019-11-14 Impact factor: 3.825