To see the other types of publications on this topic, follow the link: GCS- Glascow Coma Scale.
Journal articles on the topic 'GCS- Glascow Coma Scale'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'GCS- Glascow Coma Scale.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Maserati, Megan, Anita Fetzick, and Ava Puccio. "The Glasgow Coma Scale (GCS)." Journal of Neuroscience Nursing 48, no. 6 (December 2016): 311–14. http://dx.doi.org/10.1097/jnn.0000000000000242.
Full text
2
Setyaningrum, Niken, Nila Titis Asrining Tyas, and Agnes Destika Swacahaya Wati. "THE EFFECT OF NATURE SOUNDS MUSIC THERAPY ON THE GLASGOW COMA SCALE ON STROKE PATIENTS." Jurnal Manajemen Asuhan Keperawatan 3, no. 2 (July 15, 2019): 15–18. http://dx.doi.org/10.33655/mak.v3i2.67.
Full textAbstract:
Latar Belakang: Definisi stroke adalah disfungsi neurologis akut yang disebabkan oleh gangguan aliran darah yang timbul secara tiba-tiba, sehingga suplai darah ke otak terganggu. Di Indonesia 1 dari 7 orang meninggal karena stroke. Insiden stroke adalah 12,1 per 1.000 orang Indonesia. Terapi musik alami adalah salah satu jenis terapi non-farmakologis yang dapat meningkatkan nilai GCS. Tujuan penelitian ini untuk menganalisa efek terapi musik suara alam pada skala koma glascow pada pasien stroke. Metode: Sebuah studi pre eksperimen kuantitatif tanpa kelompok kontrol. Sampel penelitian adalah 35 pasien stroke non hemoragik. Sampel akan mendapatkan terapi musik suara alam selama 3 hari dengan durasi 20 menit dengan volume 50% atau 60dB. Data akan dianalisis menggunakan uji wilcoxon. Hasil: Hasil tes wilcoxon adalah p = 0,000. Artinya, terapi musik suara alam memberi efek pada glascow coma scale pasien stroke. Kesimpulan: Terapi musik suara alam dapat meningkatkan GCS pada pasien stroke.
3
AL-Quraan, Hamza, and Mohannad AbuRuz. "Simplifying Glasgow Coma Scale Use for Nurses." International Journal of Advanced Nursing Studies 4, no. 2 (July 4, 2015): 69. http://dx.doi.org/10.14419/ijans.v4i2.4639.
Full textAbstract:
<p>Glasgow Coma Scale (GCS) was introduced in 1974 as a tool to standardize the assessment of the level of consciousness of patients. Since it was introduced and used, GCS was considered to be the gold standard method for this purpose. Despite plenty of strengths GCS has (i.e. objectivity and easy communication on the results between the health care providers); GCS was considered to be ambiguous and confusing for nurses and infrequent users. Moreover, lack of knowledge and training about GCS might affect the accuracy and inter-rater reliability among health care professionals. The purpose of this paper was to simplify the use of GCS step by step for the beginner health care professionals.</p><p>This literature review was done by searching the following search engines: Pubmed, Midline, CINHAL, Ebsco host, and Google Scholar for the key words of: Glasgow Coma Scale (GCS), flow chart, nurses, and consciousness.Types of articles included: original research, literature review and meta-analysis. This review included the following sections:</p><p>1) Definition of the related concepts</p><p>2) The historical development of the GCS</p><p>3) How to score the GCS</p><p>4) Recommendation for clinical settings, and</p><p>5) Conclusion</p>
4
Bledsoe, Bryan E., Michael J. Casey, Jay Feldman, Larry Johnson, Scott Diel, Wes Forred, and Codee Gorman. "Glasgow Coma Scale Scoring is Often Inaccurate." Prehospital and Disaster Medicine 30, no. 1 (December 9, 2014): 46–53. http://dx.doi.org/10.1017/s1049023x14001289.
Full textAbstract:
AbstractIntroductionThe Glasgow Coma Scale (GCS) is widely applied in the emergency setting; it is used to guide trauma triage and for the application of essential interventions such as endotracheal intubation. However, inter-rater reliability of GCS scoring has been shown to be low for inexperienced users, especially for the motor component. Concerns regarding the accuracy and validity of GCS scoring between various types of emergency care providers have been expressed.Hypothesis/ProblemThe objective of this study was to determine the degree of accuracy of GCS scoring between various emergency care providers within a modern Emergency Medical Services (EMS) system.MethodsThis was a prospective observational study of the accuracy of GCS scoring using a convenience sample of various types of emergency medical providers using standardized video vignettes. Ten video vignettes using adults were prepared and scored by two board-certified neurologists. Inter-rater reliability was excellent (Cohen's κ = 1). Subjects viewed the video and then scored each scenario. The scoring of subjects was compared to expert scoring of the two board-certified neurologists.ResultsA total of 217 emergency providers watched 10 video vignettes and provided 2,084 observations of GCS scoring. Overall total GCS scoring accuracy was 33.1% (95% CI, 30.2-36.0). The highest accuracy was observed on the verbal component of the GCS (69.2%; 95% CI, 67.8-70.4). The eye-opening component was the second most accurate (61.2%; 95% CI, 59.5-62.9). The least accurate component was the motor component (59.8%; 95% CI, 58.1-61.5). A small number of subjects (9.2%) assigned GCS scores that do not exist in the GCS scoring system.ConclusionsGlasgow Coma Scale scoring should not be considered accurate. A more simplified scoring system should be developed and validated.BledsoeBE, CaseyMJ, FeldmanJ, JohnsonL, DielS, ForredW, GormanC. Glasgow Coma Scale scoring is often inaccurate. Prehosp Disaster Med. 2015;30(1):1-8.
5
Bordini, Ana Luisa, Thiago F. Luiz, Maurício Fernandes, Walter O. Arruda, and Hélio A. G. Teive. "Coma scales: a historical review." Arquivos de Neuro-Psiquiatria 68, no. 6 (December 2010): 930–37. http://dx.doi.org/10.1590/s0004-282x2010000600019.
Full textAbstract:
OBJECTIVE: To describe the most important coma scales developed in the last fifty years. METHOD: A review of the literature between 1969 and 2009 in the Medline and Scielo databases was carried out using the following keywords: coma scales, coma, disorders of consciousness, coma score and levels of coma. RESULTS: Five main scales were found in chronological order: the Jouvet coma scale, the Moscow coma scale, the Glasgow coma scale (GCS), the Bozza-Marrubini scale and the FOUR score (Full Outline of UnResponsiveness), as well as other scales that have had less impact and are rarely used outside their country of origin. DISCUSSION: Of the five main scales, the GCS is by far the most widely used. It is easy to apply and very suitable for cases of traumatic brain injury (TBI). However, it has shortcomings, such as the fact that the speech component in intubated patients cannot be tested. While the Jouvet scale is quite sensitive, particularly for levels of consciousness closer to normal levels, it is difficult to use. The Moscow scale has good predictive value but is little used by the medical community. The FOUR score is easy to apply and provides more neurological details than the Glasgow scale.
6
Starmark, Jan-Erik, Daniel Stålhammar, Eddy Holmgren, and Björn Rosander. "A comparison of the Glasgow Coma Scale and the Reaction Level Scale (RLS85)." Journal of Neurosurgery 69, no. 5 (November 1988): 699–706. http://dx.doi.org/10.3171/jns.1988.69.5.0699.
Full textAbstract:
✓ The Glasgow Coma Scale (GCS) and the Reaction Level Scale (RLS85) were compared for rating neurosurgical patients in regard to ranking order of deficit severity, interobserver variability, and coverage for relevant factors. Four physicians, four registered nurses, and four assistant nurses performed 72 pairwise ratings on 47 neurosurgical patients. The rank correlation between the GCS sum score and the RLS85 was −0.94, suggesting the same ranking order of severity and indicating that the underlying concepts of somnolence, delirium, and motor responses in coma are evaluated in the same way. By the sign test, the RLS85 was shown to have better interobserver agreement than the GCS sum score and the eye-motor-verbal (EMV) profile. The interobserver grading disagreements in both scales were distributed over the entire range of responsiveness, and for the GCS sum score they were slanted to combined segments 9 to 15. The RLS85 showed full coverage of relevant factors, while 43 (60%) of the 72 test occasions in the GCS sum score and the EMV profiles showed untestable features, most often because of patient intubation. The pseudoscore (that is, the choice of value given to untestable features) affects interobserver agreement as well as the estimated overall patient responsiveness in the GCS sum score. Assessment by the order of applying the scales showed a significant effect on the GCS eye-opening scale (p = 0.01) and the GCS sum score (p = 0.03), indicating a sensitivity to environmental stimuli unrelated to the patient's status. This study demonstrates that basically the same information as that found in the separate eye, motor, and verbal scales of the GCS can be combined directly into the RLS85, which has better interobserver agreement and better coverage than the GCS sum score.
7
Rudini, Dini. "Efektifitas Antara Alat Ukur Coma Recovery Scale – Revised (Crs-R), Full Outline Unresponsiveness (Four) Score, dan Glasgow Coma Scale (Gcs) Dalam Menilai Tingkat Kesadaran Pasien di Unit Perawatan Intensif RSUD Raden Mattaher Jambi." Jurnal Ilmiah Ilmu Terapan Universitas Jambi|JIITUJ| 2, no. 1 (June 30, 2018): 68–74. http://dx.doi.org/10.22437/jiituj.v2i1.5653.
Full textAbstract:
Penilaian kesadaran penting dilakukan pada pasien yang mengalami penurunan kesadaran pada pasien di ICU, hal ini bertujuan untuk memperkirakan prognosis pada seorang pasien. Penentuan prognosis pasien di unit perawatan intensive merupakan suatu hal yang perlu diperhatikan. Jika terjadi kesalahan dalam menentukan prognosis maka dapat mengakibatkan kesalahan dalam pemberian terapi, khususnya yang berkaitan dengan pengobatan penyakit, berdasarkan studi meta - analysis terdapat tiga alat ukur yang paling baik diantara alat-alat ukur lainnya yang digunakan untuk menilai tingkat kesadaran yaitu Glasgow Coma Scale (GCS), The Full Outline UnResponsiveness (FOUR) Score, Coma Recovery Scale - Revised (CRS-R). Ketiga alat ukur ini telah tervalidasi dan telah digunakan di beberapa rumah sakit oleh tenaga kesehatan. Dengan memperhatikan hal-hal tersebut, maka peneliti tertarik untuk melakukan penelitian di RSUD Raden Mattaher Jambi untuk melihat efektifitas antara alat ukur Coma Recovery Scale – Revised (CRS-R), Full Outline UnResponsiveness (FOUR) score, dan Glasgow Coma Scale (GCS)dalam menilai tingkat kesadaran pasien di unit perawatan intensif RSUD Raden Mattaher Jambi Tahun. Jenis penelitian yang digunakan oleh peneliti adalah penelitian studi perbandingan (comparative) dimana penelitian ini tidak memberikan perlakuan kepada subjek penelitian, penelitian ini hanya akan membandingkan 3 instrument pengkajian tingkat kesadaran. Rancangan penelitian yang digunakan adalah longitudinall, yaitu pengamatan tidak hanya dilakukan sekali. Pengambilan sampel pada penelitian ini dilakukan dengan consecutive sampling. Dalam penelitian ini menggunakan tiga instrument skala yaitu Coma Recovery Scale – Revised (CRS-R), Full Outline UnResponsiveness (FOUR) score, dan Glasgow Coma Scale (GCS). Analisis yang digunakan dalam penelitian ini adalah uji beda.Berdasarkan hasil penelitian dari 76 responden dengan penurunan kesadaran Ada perbedaan validitas dan reliabilitas antara alat ukur Glasgow Coma Scale (GCS) dan Coma Recovery Scale – Revised (CRS-R) dalam menilai tingkat kesadaran pasien di Unit Perawatan Intensive RSUD Raden Mattaher Jambi tahun 2017 terdapat satu komponen pada alat ukur GCS yaitu respon verbal yang memiliki nilai kesepakatan antar penenliti yang moderate dan terdapat dua komponen dalam alat ukur CRS-R yaitu skala fungsi oromotor/verbal dan skala fungsi komunikasi yang memiliki nilai kesepakatan antar peneliti yang baik.
8
Nining Indrawati, Christin Novita Kupa, Era Marthanti Putri, Lona Lorenza Lesimanuaya, Veronica Evi Alviolita, and Viky Septiani. "KOMPARASI GLASGOW COMA SCALE (GCS) DAN FULL OUTLINE OF UNRESPONSIVENESS (FOUR) UNTUK MENILAI MORTALITAS PADA PASIEN CEDERA KEPALA DI AREA PERAWATAN KRITIS: LITERATUR REVIEW." Journal of Health (JoH) 8, no. 1 (January 31, 2021): 19–27. http://dx.doi.org/10.30590/joh.v8i1.213.
Full textAbstract:
Abstrak
Latar Belakang: Cedera kepala merupakan penyakit kritis yang membutuhkan perawatan khusus di ruang intermediate care di Rumah Sakit. Pasien cedera kepala bisa mengalami perubahan kondisi yaitu penurunan kesadaran. Perubahan kondisi ini akan mempengaruhi prognosis dan mortalitas pasien, sehingga pada area perawatan kritis membutuhkan skala pengukuran yang tepat diantaranya Glascow Koma Scale (GCS) dan Full Outline of Un Responding (FOUR) untuk menilai tingkat kesadaran. Tujuan: Mengidentifikasi pengukuran tingkat kesadaran menggunakan GCS dan FOUR untuk menilai mortalitas pada pasien cedera kepala di area perawatan kritis. Metode: Penelitian dilakukan dengan metode literature review dengan menelaah sebelas jurnal dari Portal Garuda, EBSCO, PROQUEST, CANGAGE dan DOAJ yang dipublikasikan dari tahun 2010 sampai dengan tahun 2020. Hasil: menunjukkan GCS dan FOUR dapat digunakan dalam memprediksi mortalitas pasien cedera kepala di ruang perawatan kritis. Kesimpulan: GCS dan FOUR merupakan alat ukur yang efektif untuk menilai mortalitas pada pasien cedera kepala, tetapi pada pasien dengan intubasi akan lebih tepat menggunakan FOUR.
Kata Kunci: GCS, FOUR, Mortalitas, Cedera Kepala
9
Starmark, Jan-Erik, Eddy Holmgren, and Daniel Stålhammar. "Current reporting of responsiveness in acute cerebral disorders." Journal of Neurosurgery 69, no. 5 (November 1988): 692–98. http://dx.doi.org/10.3171/jns.1988.69.5.0692.
Full textAbstract:
✓ One hundred sixty-six papers published in seven neurosurgical journals from 1983 through 1985 have been surveyed to determine the methods used for assessment of overall patient responsiveness in acute cerebral disorders (coma grading). Fifty-one different coma scales or modifications were found. The Glasgow Coma Scale (GCS) sum score (that is, the sum of the scores of the individual eye, verbal, and motor scales) dominated (54%), and was used in 73 (76%) of 96 of the head-injury studies; in 56 (77%) of these 73 studies it was the single method of grading neurological status. The GCS sum score was used in 16 (23%) of 70 studies in patients with other etiologies. The Hunt and Hess scale was used in 26 (57%) of 46 reports of patients with subarachnoid hemorrhage. In 31 (55%) of the 56 studies of head injuries using the GCS alone, it was not obvious if the 12- or 13-grade scale was used. In 13 studies (23%) no reference to methodological investigations was made. In 44 papers (79%) the handling of untestable features, such as intubation or swollen eyes, was not reported. In the 56 studies using the GCS alone, coma was defined in many different ways and in 22 studies the definition of coma was not specified. In 63% of reports, the GCS sum score scale was combined in one to five groups of scores and this was done in 32 different ways. No information was available to describe the procedure of data aggregation or the reliability of the 13-grade GCS sum score. The lack of standardization makes it unnecessarily difficult to perform valid comparisons between different series of patients. Since the GCS sum score is the most widely used scale, it is suggested that the reporting of the GCS sum score should be standardized regarding pseudoscoring, coma definition, and use of combined scores. Further studies on the reliability of the GCS sum score are needed.
10
Reddy, A. Manikanteswara, G. Sreedhar, and Gangadhar B. Belavadi. "Correlation of risk factors with Glasgow coma scale to predict the severity and outcome of children with non-traumatic coma." International Journal of Contemporary Pediatrics 6, no. 4 (June 27, 2019): 1524. http://dx.doi.org/10.18203/2349-3291.ijcp20192749.
Full textAbstract:
Background: Non-traumatic coma is the problem of pediatric group, accounts 10-15% in hospital admissions. Assessment of the severity of coma is useful to speculate the survival. The aim was to assess outcome in pediatric non-traumatic coma with role of Glasgow coma scale and modified Glasgow coma scale.Methods: Total of 80 cases of non-traumatic coma between 1 month to 12 years, coma severity was assessed by using Glasgow coma scale. A score of less than 8 and more than 8 were used for analysis of outcome.Results: The maximum number of patents with non-traumatic coma were in the age group of 1 month-5 years, 40 children (50%). On neurological examination 42 (52.5%) children has GCS score of >8, 38 cases (47.5%) has GCS <8, 20 children had meningeal signs, 7 children had cranial nerve deficit (7th nerve), 9 children had decebrate posture. Out of 80 cases, 8 cases expired (10%), 4 cases were discharged against medical advice (4%), 68 cases were improved and discharged (85%), among these, 8 cases were discharged with complication (11.7%). Overall mortality was (10%) (8/80), males outnumbered females in frequency with ratio of 1.28:1. CNS infection accounted for almost about 66%.Conclusions: Children with GCS and MGCS scores of less than 8 have poor prognosis and a very high probability of death. Those with GCS score of more than 8 have good prognosis. Identification of these cases at the outset can help prepare the treating physician to plan critical care referral and to give a preliminary assessment of outcome to the family.
11
Waterhouse, Catheryne. "The Glasgow Coma Scale Pupils score: a nurse's perspective." British Journal of Neuroscience Nursing 16, no. 2 (April 2, 2020): 89–92. http://dx.doi.org/10.12968/bjnn.2020.16.2.89.
Full textAbstract:
The Glasgow Coma Scale Pupils (GCS–P) score is calibrated from 1 to 15 and is calculated by subtracting the patient's pupil reactivity score (PRS) from their Glasgow Coma Scale score. The additional clinical information gained from the patient's PRS (0–2) enables practitioners to access a more qualitative framework to facilitate discussion of predictive information with families regarding the patient's potential for recovery or good outcome following a severe brain injury.
12
Astuti, Ewi, Syaiful Saanin, and Edison Edison. "HUBUNGAN GLASGOW COMA SCALE DENGAN GLASGOW OUTCOME SCALE BERDASARKAN LAMA WAKTU TUNGGU OPERASI PADA PASIEN PERDARAHAN EPIDURAL." Majalah Kedokteran Andalas 39, no. 2 (August 31, 2016): 50. http://dx.doi.org/10.22338/mka.v39.i2.p50-57.2016.
Full textAbstract:
Cedera kepala merupakan penyebab kematian terbanyak dari keseluruhan angka kematian yang diakibatkan trauma. Epidural Hematoma (EDH) merupakan jenis yang paling banyak menjadi perhatian para klinisi dan peneliti karena frekwensi kejadiannya yang tinggi. Operasi EDH dianjurkan dilakukan sesegera mungkin setelah diagnosis ditegakkan. Operasi yang dilakukan sebelum waktu 4 jam, memberikan hasil perbaikan yang bermakna. Glasgow Coma Scale (GCS) dan waktu prehospital merupakan faktor terbesar yang mempengaruhi prognosa penderita EDH. Penilaian outcome suatu tindakan operasi dapat dinilai dengan Glassgow outcome scale (GOS). Penelitian ini bertujuan untuk menilai hubungan GSC dengan GOS berdasarkan lama waktu tunggu operasi pada pasien EDH di Instalasi Gawat Darurat RSUP Dr.M.Djamil Padang. Pada sampel dilakukan penilaian GCS dan GOS. Dari 10 sampel penelitian didapatkan penderita dengan jenis kelamin terbanyak laki-laki (60%), usia tertinggi 35-45 tahun (60%), GCS awal 9-12 (70 %), lama waktu tunggu terbanyak > 4 jam (80 %), skor GOS terbanyak adalah 4 (80%). Tidak terdapat hubungan yang bermakna antara GCS saat awal masuk dengan nilai GOS (p>0,05), tetapi terdapat hubungan yang bermakna antara lama waktu tunggu setelah cedera kepala sampai dilakukan operasi dengan GOS (p<0,05).
13
Lane, Peter L., Amado Alejandro Báez, Thomas Brabson, David D. Burmeister, and John J. Kelly. "Effectiveness of a Glasgow Coma Scale Instructional Video for EMS Providers." Prehospital and Disaster Medicine 17, no. 3 (September 2002): 142–46. http://dx.doi.org/10.1017/s1049023x00000364.
Full textAbstract:
AbstractIntroduction:The Glasgow Coma Scale (GCS) is the standard measure used to quantify the level of consciousness of patients who have sustained head injuries. Rapid and accurate GCS scoring is essential.Objective:To evaluate the effectiveness of a GCS teaching video shown to prehospital emergency medical services (EMS) providers.Methods:Participants and setting—United States, Mid-Atlantic region EMS providers. Intervention—Each participant scored all of the three components of the GCS for each of four scenarios provided before and after viewing a video-tape recording containing four scenarios. Design—Before-and-after single (Phase I) and parallel Cohort (Phase II). Analysis— Proportions of correct scores were compared using chi-square, and relative risk was calculated to measure the strength of the association.Results:75 participants were included in Phase I. In Phase II, 46 participants participated in a parallel cohort design: 20 used GCS reference cards and 26 did not use the cards. Before observing the instructional video, only 14.7% score all of the scenarios correctly, where as after viewing the video, 64.0% scored the scenarios results were observed after viewing the video for those who used the GCS cards (p = 0.001; RR = 2.0; 95% CI = 1.29 to 3.10) than for those not using the cards (p <0.0001; RR = 10.0; 95% CI = 2.60 to 38.50).Conclusions:Post-video viewing scores were better than those observed before the video presentation. Ongoing evaluations include analysis of longterm skill retention and scoring accuracy in the clinical environment.
14
Ley, Eric J., Morgan A. Clond, Omar N. Hussain, Marissa Srour, James Mirocha, Marko Bukur, Dan R. Margulies, and Ali Salim. "Mortality by Decade in Trauma Patients with Glasgow Coma Scale 3." American Surgeon 77, no. 10 (October 2011): 1342–45. http://dx.doi.org/10.1177/000313481107701015.
Full textAbstract:
The aim of this study was to assess how increasing age affects mortality in trauma patients with Glasgow Coma Scale (GCS) 3. The Los Angeles County Trauma System Database was queried for all patients aged 20 to 99 years admitted with GCS 3. Mortality was 41.8 per cent for the 3306 GCS 3 patients. Mortality in the youngest patients reviewed, those in the third decade, was 43.5 per cent. After logistic regression analysis, patients in the third decade had similar mortality rates to patients in the sixth (adjusted OR, 0.88; CI, 0.68 to 1.14; P = 0.33) and seventh decades (adjusted OR, 0.96; CI, 0.70 to 1.31; P = 0.79). A significantly lower mortality rate, however, was noted in the fifth decade (adjusted OR, 0.76; CI, 0.61 to 0.95; P = 0.02). Conversely, significantly higher mortality rates were noted in the eighth (adjusted OR, 1.93; CI, 1.38 to 2.71; P = 0.0001) and combined ninth/tenth decades (adjusted OR, 2.47; CI, 1.71 to 3.57; P < 0.0001). Given the high survival in trauma patients with GCS 3 as well as continued improvement in survival compared with historical controls, aggressive care is indicated for patients who present to the emergency department with GCS 3.
15
Islam, K. M. Tarikul, Md Motasimul Hasan, Sukriti Das, Ehsan Mahmood, and Kanak Kanti Barua. "Correlation between Glasgow coma scale on admission and clinical outcome of patients with unilateral chronic subdural hematoma after surgery." Bangabandhu Sheikh Mujib Medical University Journal 10, no. 2 (June 7, 2017): 115. http://dx.doi.org/10.3329/bsmmuj.v10i2.32711.
Full textAbstract:
<p>This study was undertaken to determine the influence of Glasgow coma scale (GCS) on admission on clinical outcome of patients with unilateral chronic subdural hematoma after surgery. A cross- sectional study was conducted on 33 consecutive patients, among them 28 were male, 5 were female with GCS 6 to 15. 19 patients out of 22 who had GCS 14-15 had favorable GOS at 24 hours as compared to 2 out of 7 in GCS 9-13 group and none in GCS ≤8 group. All patients (22 out of 22) had favorable GOS at the time of discharge in GCS 14-15 group while 8 out of 9 had favorable GOS in GCS 9-14 group and 1 out of 2 patients had favorable GOS in GCS ≤8 group. Chi square test showed significant difference in outcome between 14-15, 9-13 and ≤8 GCS groups (p values 0.001, 0.015, 0.013 respectively). In conclusion, clinical outcome of patients with unilateral chronic subdural hematoma depends on Glasgow coma scale on admission. </p>
16
Arifin, Nahari, Irawan Mangunatmadja, Antonius Pudjiadi, and Sudung O. Pardede. "Correlation between brain injury biomarkers and Glasgow coma scale in pediatric sepsis." Paediatrica Indonesiana 52, no. 2 (April 30, 2012): 111. http://dx.doi.org/10.14238/pi52.2.2012.111-117.
Full textAbstract:
Background Sepsis in children, with or without multiple organfailure, causes increased susceptibility to brain injury due tosystemic insults. Brain injury in sepsis is difficult to recognizeclinically. Neuron-specific enolase (NSE) and S-lOOB have beenextensively studied in brain injuries and appear to be promisingalternative biomarkers.Objectives To determine if there is a correlation between theGlasgow coma scale (GCS) and NSE as well as S-lOOB levels, inchildren with sepsis.Methods We performed an analytical study on septic childrenaged > 2 years. GCS scores were assessed on the first and thirddays of admission. Blood specimens to test for NSE and S-lOOBwere drawn on the first day of admission and stored at -70QC forfurther analysis at the end of the study.Results Out of 35 patients, 30 met the inclusion criteria. Postanalysis,one subject with NSE above the maximum level wasexcluded. Negative correlations were found between GCS scoreand NSE, as well as between GCS and S-lOOB levels. Analysisrevealed a significant ROC for NSE, but not for S-lOOB. NSEconcentration of 8.1 /.lg/L was the cut-off point for GCS scoresbelow 12.Conclusions There were negative correlations between GCSand NSE levels, as well as between GCS and S- lOOB levels. Thepredictive value ofNSE level was a cut-off point of 8.1 /.lg/L forGCS scores below 12. [Paediatr lndones. 2012;52:111-17]
17
Basauhra Singh, Harvinderjit Kaur a/p, Mei Chan Chong, Hari Chandran a/l Thambinayagam, Mohd Idzwan bin Zakaria, Siew Ting Cheng, Li Yoong Tang, and Nurul Hafizan Azahar. "Assessing Nurses Knowledge of Glasgow Coma Scale in Emergency and Outpatient Department." Nursing Research and Practice 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/8056350.
Full textAbstract:
Assessment of level of consciousness using the Glasgow Coma Scale (GCS) is a tool requiring knowledge that is important in detecting early deterioration in a patient’s level of consciousness. Critical thinking used with the skill and knowledge in assessing the GCS is the foundation of all nursing practice. This study aims to explore the knowledge and competence in assessing the GCS among staff nurses working in the Emergency and Outpatient Departments. This is a quantitative descriptive cross-sectional study design using the GCS Knowledge Questionnaire. Convenience sampling method was used. Nurses in these Departments were asked to partake in the survey. Data collected was analyzed using the Statistical Package of Social Sciences (SPSS) version 20. Descriptive and Pearson’s chi square was used. Result showed that 55.56% of nurses had poor knowledge followed by 41.48% and 2.96% with satisfactory knowledge and good knowledge, respectively. The result on the association between knowledge and education level showed a significant association between the two variables (X2=18.412, df = 3, n=135, and p<0.05). There was also a significant correlation between knowledge and age group (X2=11.085, df = 2, n=135, and p<0.05). Overall, this study supports that good knowledge and skill are important in assessing GCS level.
18
Bansal, Shikha, and Rajiv Chawla. "Awareness of Glasgow Coma Scale in anaesthesiology post-graduates in India: A survey." Journal of Neuroanaesthesiology and Critical Care 03, no. 03 (August 2016): 227–32. http://dx.doi.org/10.4103/2348-0548.190068.
Full textAbstract:
Abstract Background: Glasgow Coma Scale (GCS) is a universal clinical means of quantifying the level of impaired consciousness. It has completed 40 years and has stood the test of time. The assessment is best when done by trained personnel. Anaesthesiologists often manage unconscious patients. Thus, they must be well versed with GCS. This survey aimed to assess the awareness of GCS in anaesthesiology post-graduates in India. Methods: A questionnaire-based survey was carried out in 250 anaesthesiology post-graduates attending a refresher course in September 2014. Subjects and Methods: The questionnaire had 14 questions. Four questions were about the respondent, 5 questions on theoretical information and 5 questions on clinical scenarios. The available data were analysed using Epi Info. Results were considered statistically significant when P < 0.05. Results: Response was received from 174 students (response rate: 70%). Ninety percent of students felt that GCS is important in assessing unconscious patients, 94% students used GCS for unconscious patients. Fifty-eight percent of students have been formally trained in GCS. Mean of correct answers to theoretical questions was 3.98 ± 0.71. Mean of correct answers to clinical questions was 3.2 ± 1.24. Difference between the two means is 0.78. This difference is considered to be statistically significant with P < 0.0001. Conclusions: While the post-graduates are well versed with ‘theoretical aspects’ of GCS, they need to strengthen their skills on clinical application. Hence, there is a need for reinforcement of GCS training for anaesthesiology post-graduates.
19
Nair, Sharath S., Anilkumar Surendran, Rajmohan B. Prabhakar, and Meer M. Chisthi. "Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study." International Surgery Journal 4, no. 2 (January 25, 2017): 656. http://dx.doi.org/10.18203/2349-2902.isj20170209.
Full textAbstract:
Background: Head injuries are a major cause of mortality and morbidity across the world. Effective initial assessment and early intervention is of importance in patients with traumatic brain injury, so as to ensure the maximum favorable outcome. Glasgow Coma Scale is the widely accepted scale to assess severity in head injury patients, albeit with many inadequacies. The objective of this study was to test the validity of full outline of unresponsiveness score, an alternate tool, in assessing severity in patients with traumatic brain injury.Methods: This was a descriptive study, conducted on 69 patients admitted to the general surgical and neuro-surgical wards of Government Medical College, Trivandrum, India with traumatic head injury. For all these patients, full outline of unresponsiveness score and Glasgow Coma Scale were calculated at the time of presentation and serially thereafter. The predictive value of full outline of unresponsiveness score as well as its correlation with Glasgow Coma Scale was studied.Results: A statistically significant correlation was found between full outline of unresponsiveness score and Glasgow Coma Scale in estimating the severity of head injury. Also Full Outline of unresponsiveness score was able to furnish better details about the neurological status of trauma patients.Conclusions: As per the results, it can be concluded that the full outline of unresponsiveness score can be applied as an ideal tool to evaluate consciousness levels and patients’ status in patients with traumatic head injury. It can be used as the ideal replacement for Glasgow Coma Scale.
20
Takagi, Kiyoshi, Akira Tamura, Tadayoshi Nakagomi, Hitoshi Nakayama, Osamu Gotoh, Kensuke Kawai, Mamoru Taneda, Nobuyuki Yasui, Hiromu Hadeishi, and Keiji Sano. "How should a subarachnoid hemorrhage grading scale be determined? A combinatorial approach based solely on the Glasgow Coma Scale." Journal of Neurosurgery 90, no. 4 (April 1999): 680–87. http://dx.doi.org/10.3171/jns.1999.90.4.0680.
Full textAbstract:
Object. The purpose of this study was to present a combinatorial approach used to develop a subarachnoid hemorrhage (SAH) grading scale based on the patient's preoperative Glasgow Coma Scale (GCS) score.Methods. There are 4094 different combinations that can be used to compress the 13 scores of the GCS into two to 12 grades. Break points, the positions in the scale in which two adjacent scores connote a significantly different outcome, are obtained by a direct comparison of the GCS and the Glasgow Outcome Scale (GOS). Guided by the break points, the number of combinations to be considered can be limited. All possible combinations are statistically analyzed with respect to intergrade differences in outcome. Single combinations, with the maximum number of grades having maximum intergrade outcome differences for each corresponding set of adjacent grades, must be selected. The authors verified the validity of this combinatorial approach by retrospectively analyzing 1398 consecutive patients with aneurysmal SAH who underwent surgery within 7 days of the last hemorrhage episode. The patients' GCS scores were assessed just before surgery and their GOS scores were estimated 6 months post-SAH. The combinatorial approach yields only one acceptable grading scale: I (GCS Score 15); II (GCS Scores 11–14); III (GCS Scores 8–10); IV (GCS Scores 4–7); and V (GCS Score 3).Conclusions. The combinatorial approach, guided by the break points, is so simple and systematic that it can be used again in the future when revision of the grading scale becomes necessary after development of new and effective treatment modalities that improve patients' overall outcome.
21
Dai, Dapeng, Yong Sun, Chengzhang Liu, Houxun Xing, Binyan Wang, Xianhui Qin, Xiguang Liu, and Aimin Li. "Association of Glasgow Coma Scale with Total Homocysteine Levels in Patients with Hemorrhagic Stroke." Annals of Nutrition and Metabolism 75, no. 1 (2019): 9–15. http://dx.doi.org/10.1159/000501191.
Full textAbstract:
Objectives: We aimed to evaluate the association between Glasgow Coma Scale (GCS) and total homocysteine (tHcy) levels and examine the possible effect modifiers in patients with hemorrhagic stroke. Methods: A total of 1,516 participants with hemorrhagic stroke and having the complete data on baseline GCS and tHcy measurements were included in the final analysis. Results: The mean (SD) of age, tHcy, and GCS levels were 61.5 (11.3) years, 17.0 (10.3) μmol/L, and 13.9 (2.2), respectively. Compared with participants with severe damage (GCS <9), those with mild damage (GCS ≥13) had significantly lower transformed tHcy levels (β = –2.46; 95% CI –4.80 to –0.12). Consistently, a significantly lower transformed tHcy levels were found in participants with mild damage (GCS ≥13; β = –1.37; 95% CI –2.66 to –0.08) compared with those with moderate to severe damage (GCS <13). In the stratified analysis, a stronger inverse association between GCS categories (≥13 vs. <13) and tHcy concentrations was observed in ever smokers (vs. never; p for interaction = 0.045), and in participants with systolic blood pressure (SBP) ≥160 mm Hg (vs. <160 mm Hg; p for interaction = 0.031), or total cholesterol (TC) ≥5.2 mmol/L (vs. <5.2 mmol/L; p for interaction = 0.025). Conclusion: There was an inverse association between GCS level and tHcy concentration among patients with hemorrhagic stroke, especially in ever smokers or in participants with higher SBP or TC levels.
22
Alhassan, Afizu, Abdul-Ganiyu Fuseini, and Ajara Musah. "Knowledge of the Glasgow Coma Scale among Nurses in a Tertiary Hospital in Ghana." Nursing Research and Practice 2019 (June 24, 2019): 1–7. http://dx.doi.org/10.1155/2019/5829028.
Full textAbstract:
Background. Knowledge of the Glasgow Coma Scale (GCS) is recognized as an asset to all clinical nurses. However, many studies in different countries have reported low levels of knowledge of the GCS among nurses. Little is known about this subject in Ghana. Objectives. The aim of this study was to assess the knowledge of Ghanaian nurses about the Glasgow Coma Scale and identify factors associated with their knowledge. Method. This was a descriptive cross-sectional study involving a convenience sample of 115 nurses from a large teaching hospital in Ghana. We collected data using a structured questionnaire and analysed the data using descriptive statistics, Pearson’s correlation, independent samples t-test, and one-way ANOVA. Results. A little more than half of the participants (50.4%) had low knowledge of the GCS as a whole. However, with respect to basic theoretical concepts of the GCS, 62.6% of the participants had good knowledge about it, while only 5.2% demonstrated good knowledge on application of the basic knowledge in clinical scenarios. Working in Neurosurgical ward, female gender, and weekly performance of the GCS were associated with higher levels of knowledge. Academic qualification, years of experience as a nurse, and refresher training on GCS were not associated with knowledge. Conclusion. The findings from this study showed that nurses in Ghana have low levels of knowledge about the GCS. A more structured approach to teaching the GCS that is very thorough and done with demonstrations should be implemented to improve nurses’ knowledge on the GCS.
23
Salottolo, Kristin, Ripul Panchal, Robert M. Madayag, Laxmi Dhakal, William Rosenberg, Kaysie L. Banton, David Hamilton, and David Bar-Or. "Incorporating age improves the Glasgow Coma Scale score for predicting mortality from traumatic brain injury." Trauma Surgery & Acute Care Open 6, no. 1 (February 2021): e000641. http://dx.doi.org/10.1136/tsaco-2020-000641.
Full textAbstract:
BackgroundThe Glasgow Coma Scale (GCS) score has been adapted into categories of severity (mild, moderate, and severe) and are ubiquitous in the trauma setting. This study sought to revise the GCS categories to account for an interaction by age and to determine the discrimination of the revised categories compared with the standard GCS categories.MethodsThe American College of Surgeons National Trauma Data Bank registry was used to identify patients with traumatic brain injury (TBI; ICD-9 codes 850–854.19) who were admitted to participating trauma centers from 2010 to 2015. The primary exposure variables were GCS score and age, categorized by decade (teens, 20s, 30s…, 80s). In-hospital mortality was the primary outcome for examining TBI severity/prognostication. Logistic regression was used to calculate the conditional probability of death by age decade and GCS in a development dataset (75% of patients). These probabilities were used to create a points-based revision of the GCS, categorized as low (mild), moderate, and high (severe). Performance of the revised versus standard GCS categories was compared in the validation dataset using area under the receiver operating characteristic (AUC) curves.ResultsThe final population included 539,032 patients with TBI. Age modified the performance of the GCS, resulting in a novel categorization schema for each age decile. For patients in their 50s, performance of the revised GCS categories mirrored the standard GCS categorization (3–8, 9–12, 13–15); all other revised GCS categories were heavily modified by age. Model validation demonstrated the revised GCS categories statistically significantly outperformed the standard GCS categories at predicting mortality (AUC: 0.800 vs 0.755, p<0.001). The revised GCS categorization also outperformed the standard GCS categories for mortality within pre-specified subpopulations: blunt mechanism, isolated TBI, falls, non-transferred patients.DiscussionWe propose the revised age-adjusted GCS categories will improve severity assessment and provide a more uniform early prognostic indicator of mortality following traumatic brain injury.Level of evidenceIII epidemiologic/prognostic.
24
Heard, Kennon, and Vikhyat S. Bebarta. "Reliability of the Glasgow Coma Scale for the emergency department evaluation of poisoned patients." Human & Experimental Toxicology 23, no. 4 (April 2004): 197–200. http://dx.doi.org/10.1191/0960327104ht436oa.
Full textAbstract:
The Glasgow Coma Scale (GCS) was developed for monitoring the mental status of head-injured patients in the intensive care unit. The purpose of this study is to determine the inter-rater reliability of the GCS for poisoning patients in the emergency department. Methods: This was a prospective, observational study. Two observers used a standard assessment checklist to determine the GCS of suspected poisoning patients. Inter-rater reliability was assessed with a weighted Kappa score. Results: A total of 39 patients were enrolled. Weighted kappa for the total GCS demonstrated excellent agreement. Agreement was also good for each component of the score. Conclusion: The GCS is a reliable tool for the evaluation of mental status of poisoning patients in the emergency department.
25
Laforce, Robert, Hélène Khuong, Jean-Luc Gariépy, Geneviève Milot, and Martin Savard. "Reversible Parinaud Syndrome Following Intraventricular Thrombolysis." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 36, no. 1 (January 2009): 95–97. http://dx.doi.org/10.1017/s0317167100006399.
Full textAbstract:
A 57-year-old daycare educator presented as a drowsy but oriented individual with a history of sudden and severe headache associated with vomiting. She had no previous medical or neurological history. Examination showed no focal signs and routine laboratory studies were unremarkable. Head computed tomogram (CT) revealed a Fisher grade IV subarachnoid hemorrhage in the posterior fossa with extensive intraventricular hemorrhage (Graeb 8/12, see Figures 1A and 1B) which was shown to originate from a left Posterior Inferior Cerebellar Artery (PICA) aneurysm on CT angiography and treated successfully with endovascular embolization. Five days later she deteriorated her level of consciousness (Glascow coma scale [GCS] 8/15). The CT scan showed moderate hydrocephalus and a ventricular drain was placed. She improved clinically but remained disoriented with slowed information processing skills.
26
Bajaj, Jitin, Sanjay Rathore, Vijay Parihar, Pawan Agarwal, Yad Ram Yadav, and Dhananjaya Sharma. "Teaching Glasgow Coma Scale Assessment by Videos: A Prospective Interventional Study among Surgical Residents." Journal of Neurosciences in Rural Practice 11, no. 03 (May 20, 2020): 381–84. http://dx.doi.org/10.1055/s-0040-1709263.
Full textAbstract:
Abstract Objective Glasgow Coma Scale (GCS) assessment is vital for the management of various neurological, neurosurgical, and critical care disorders. Learning GCS scoring needs good training and practice. Due to limitation of teachers, the new entrants of the clinical team find it difficult to learn and use it correctly. Training through videos is being increasingly utilized in the medical field. This study aimed to evaluate the efficiency of video teaching of GCS scoring among general surgery residents. Materials and Methods A prospective study was done utilizing the freely available video at glasgowcomascale.org. The participants (general surgery residents, 1st–3rd year) were asked to assess and record their responses related to GCS both before and after watching the video. A blinded neurosurgeon recorded the correct responses separately. Statistical Analysis The difference between correct responses of the residents before and after watching the video was calculated using the “chi-square test.” p-Value ≤ 0.05 was taken as significant. Results There was a significant improvement in GCS scoring by residents after watching the videos (p < 0.05). On estimating the responses separately, all the three responses (eye, verbal, and motor) improved significantly for 1st-year residents while only the motor response improved significantly for 2nd- and 3rd-year residents. The mode subjective improvement for the 1st-, 2nd-, and 3rd-year residents was 5, 4, and 3, respectively. Conclusion Training GCS scoring through videos is an effective way of teaching the surgery residents with maximum benefit to the junior-most ones.
27
Marbun, Agnes Silvina, Elida Sinuraya, Amila Amila, and Galvani Volta Simanjuntak. "Glasgow Coma Scale (GCS) dan Tekanan Darah Sistolik Sebagai Prediktor Outcome Pasien Cedera Kepala." Bali Medika Jurnal 7, no. 2 (December 28, 2020): 146–53. http://dx.doi.org/10.36376/bmj.v7i2.140.
Full textAbstract:
Dikarenakan angka kematian pasien cedera kepala tinggi, sehingga diperlukan penilaian awal yang akurat untuk memprediksi hasil dan asuhan keperawatan yang sesuai dengan kondisi pasien. Tujuan penelitian ini adalah untuk mengetahui GCS, tekanan darah sistolik, dan frekuensi pernapasan yang dapat menjadi prediktor mortalitas pasien cedera kepala di RSUP Haji Adam Malik Medan. Desain penelitian ini adalah observasional analitik dengan pendekatan retrospektif. Populasi dalam penelitian ini adalah rekam medis pasien cedera kepala bulan Januari-Desember 2018 di RSUP Haji Adam Malik Medan. Pengambilan sampel dilakukan dengan teknik purposive sampling dengan kriteria: memiliki skor GCS, tekanan darah sistolik, dan frekuensi pernafasan pada saat pasien masuk IGD dan bukan pasien pindahan. Hasil uji regresi logistik menunjukkan adanya hubungan GCS (p 0,000; OR 3,299) dan tekanan darah (p 0,024; OR 1,044) terhadap kematian pasien cedera kepala. Kesimpulan bahwa GCS dan tekanan darah secara statistik dapat meningkatkan prediksi mortalitas pada pasien cedera kepala.
28
Fiddiyanti, ilma, Indarti Trimurtini, and Arzun Tri Ghana. "KORELASI CT-SCAN KEPALA DENGAN GLASGOW COMA SCALE (GCS) 13-15 PADA PASIEN CEDERA KEPALA RINGAN DI RUMAH SAKIT DUSTIRA CIMAHI." Medika Kartika Jurnal Kedokteran dan Kesehatan, Volume 3 No 2 (April 30, 2020): 113–25. http://dx.doi.org/10.35990/mk.v3n2.p113-125.
Full textAbstract:
Cedera kepala adalah cedera mengenai kepala secara mekanik langsung atau tidak langsung. Cedera kepala dapat menyebabkan gangguan neurologis, lesi di kulit kepala, fraktur di tulang tengkorak, robekan di selaput otak, dan kerusakan jaringan otak. Cedera kepala ringan bila penilaian skor Glasgow Coma Scale (GCS) 13-15. Computed Tomography Scanner (CT-Scan) adalah pemeriksaan cedera kepala yang mutakhir, sederhana, cepat dikerjakan, dan tidak invasif. CT-Scan dapat memberi penjelasan mengenai proses trauma diantaranya menilai adanya fraktur intrakranial, perdarahan, dan tekanan intrakranial akibat perdarahan. Menilai tanda dan gejala berdasarkan GCS dihubungkan dengan gambaran CT-Scan akan berguna mendiagnosis kelainan kranial. Penelitian ini bertujuan untuk mengetahui korelasi antara CT-Scan dan hasil nilai skor Glasgow Coma Scale (GCS) 13-15 pada pasien cedera kepala ringan di RS Dustira Cimahi. Penelitian ini merupakan penelitian analitik dengan pengambilan data sekunder sesuai kriteria inklusi yang diambil dari rekam medik pasien. Analisis data menggunakan korelasi Spearman dengan p<0,05. Hasil penelitian menunjukkan bahwa pasien yang didiagnosis cedera kepala ringan di Radiologi Rumah Sakit Dustira Cimahi selama bulan Januari sampai dengan Desember tahun 2018 sebanyak 146 pasien, terdapat 68 pasien yang memenuhi kriteria inklusi yang melakukan CT-Scan. Gambaran hasil CT Scan pada pasien cedera kepala ringan terbanyak adalah perdarahan yaitu sejumlah 43 orang (63,24 %), gambaran CT scan dengan hasil normal ditemukan sebanyak 21 orang (30,88%), dan gambaran CT scan dengan hasil fraktur ditemukan sebanyak 4 orang (5,88%). Berdasarkan hasil penelitian terdapat korelasi yang bermakna dengan p=0,026 antara hasil CT-Scan kepala pasien dengan derajat cedera kepala ringan dengan Glasgow Coma Scale (GCS).
29
Vahdati, Samad Shams, Jafar Ghobadi, MohammadReza Bazavar, and Fatemeh Seifar. "Comparison of interrater reliability and predictive validity of FOUR score and Glasgow Coma Scale in multi traumatic patients." Advances in Bioscience and Clinical Medicine 5, no. 4 (October 1, 2017): 17. http://dx.doi.org/10.7575/aiac.abcmed.17.05.04.03.
Full textAbstract:
Background: Multi traumatic injuries impose health care concern and major burden for society. The Glasgow Coma Scale (GCS) is a routine scale for assessing levels of consciousness and prognosis of traumatic patients. The Full outline of unresponsiveness (FOUR) score is a new coma scale developed to overcome the limitations of GCS. In this prospective study, we aimed to compare the predicting outcomes and inter-rater reliability of the GCS and FOUR score in a group of multi traumatic patients. 96 consecutive multi trauma patients admitted in emergency departments were enrolled in the study. GCS and FOUR score were documented on arrival to the emergency room. Their correlation with patients ‘outcomes was analyzed. In terms of predictive power for in-hospital mortality, calculated mortality rate was 33.1 for FOUR score and 30.21 for GCS. Mean value of GCS and FOUR score were 14.83 and 13.68, respectively. Mortality rate was determined 9.3% and mean duration of hospitalization was 7.86±8.73 days. In addition, inter-rater reliability was determined κ = 0.84 ± 0.01 for GCS score and κ = 0.86 ± 0.01 for FOUR score rating. Inter-rater reliability and outcome predictability for FOUR score was superior to the GCS in this study, therefore FOUR score can be considered as a viable alternative to the GCS in the emergency department by accurately predicting outcome and improving the quality of management in trauma patients.
30
Deshpande, Archana, Nitin Gaikwad, and Sanjay Deshpande. "Study of Glasgow Coma Scale Score and QTc Interval in Prognosis of Organophosphate Compound Poisoning." Indian Journal of Clinical Medicine 3 (January 2012): IJCM.S9807. http://dx.doi.org/10.4137/ijcm.s9807.
Full textAbstract:
We assessed the applicability of the Glasgow Coma Scale (GCS) and the QT interval (QTc) to predicting outcomes in patients with organophosphate (OP) poisoning. In the hospital setting, QTc and GCS were monitored in each patient at admission. Patients with respiratory failure were compared to patients without these complications, and mortality was compared between groups. We found that the group with complications had a significantly longer QTc and a lower GCS score, a higher number of intubations, and worse outcomes ( P < 0.05). GCS score and QTc have been shown to be equally good in predicting respiratory failure and hospital mortality in patients with OP poisoning. These results suggest that during initial out-of-hospital care of patients with OP poisoning, it is essential to monitor the QTc and the GCS score. The simplicity and promptness of these methods will allow providers to perform early and effective triage.
31
Akdur, Okhan, Polat Durukan, Seda Ozkan, Levent Avsarogullari, Alper Vardar, Cemil Kavalci, and Ibrahim Ikizceli. "Poisoning severity score, Glasgow coma scale, corrected QT interval in acute organophosphate poisoning." Human & Experimental Toxicology 29, no. 5 (March 4, 2010): 419–25. http://dx.doi.org/10.1177/0960327110364640.
Full textAbstract:
The aim of this study was to investigate effectiveness of the poisoning severity score (PSS), Glasgow coma scale (GCS), and corrected QT (QTc) interval in predicting outcomes in acute organophosphates (OP) poisoning. Over a period of 2 years, 62 patients with OP poisoning were admitted to emergency department (ED) of Erciyes University Medical School Hospital. The age, sex, cause of contact, compound involved, time elapsed between exposure and admission to the ED, duration of hospital stay, and cardiac manifestations at the time of presentation were recorded. GCS and poisoning severity score (PSS) was calculated for each patient. Electrocardiogram (ECG) analysis included the rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals. Sixty-two patients with OP poisoning presented to our ED from January 2007 to December 2008 from which 54 patients were included in the study. The mean age was 34.1 ± 14.8 years. Of the cases, 53.7% were female. Twenty-six patients had a prolonged QTc interval. Mean PSS of men and women was 1.8 ± 1.0. No statistically significant correlation was found between the PSS and QTc intervals of the cases. A significant correlation was determined between the GCS and PSS of grade 3 and grade 4 cases. GCS is a parameter that helps clinician to identify advanced grade OP poisoning patients in the initial assessment in the ED. However, ECG findings, such as prolonged QTc interval, are not effective in determination of short-term prognosis and show no relationship with PSS.
32
Sedain, Prativa, and Mina Kumari Bhusal. "Knowledge Regarding Glasgow Coma Scale among Nurses Working at Selected Hospitals of Chitwan, Nepal." Journal of College of Medical Sciences-Nepal 15, no. 4 (December 31, 2019): 276–81. http://dx.doi.org/10.3126/jcmsn.v15i4.24529.
Full textAbstract:
Background: Glasgow Coma Scale (GCS) refers to the internationally standardized measurement tool used to check the level of consciousness. The objective of this study is to find out the knowledge regarding Glasgow Coma Scale among nurses working in selected Hospital Bharatpur, Chitwan.
Methods: A descriptive cross-sectional study design was used with 154 nurses working in the different critical wards by using Non-probability, convenient sampling technique. Data was collected by using structured, self-administered questionnaire
Result: Result of this study revealed that mean age of the respondents was 23.24. Majority of the respondents belongs to age group 20-24 years (72.1%), Proficiency Certificate Level Nursing (69.5%), education in private institution (90.9%), staff nurse (89.6%), <12-month experience (58.9%), receive in-service education (57.8%). Only 33.1% of the respondent had good level of knowledge. Likewise, 66.9% respondents had good knowledge regarding eye opening component, 33.0% had good knowledge regarding motor component and 66.2% had good knowledge regarding verbal response of GCS. The significant influencing variable for the level of knowledge are educational institute (p=0.028), availability of protocol on GCS (p=0.048) and habit of self-directed learning (p=0.036).
Conclusions: It is concluded that majority of respondents have unsatisfactory level of knowledge regarding GCS. Therefore, knowledge upgrading programs should be conducted through in-service education and training.
33
Kasem, Eman B., Sahar Y. Mohammad, and Dalia A. Amin. "Glasgow Coma Scale versus Full Outline of Unresponsiveness Scale in Predicting Discharge Outcomes of Traumatic Brain Injury." Evidence-Based Nursing Research 1, no. 4 (September 27, 2019): 9. http://dx.doi.org/10.47104/ebnrojs3.v1i4.70.
Full textAbstract:
Context: Neurological assessment is an essential element of early warning scores used to recognize and early save the lives of critically ill patients.Aim: This study aimed to compare the full outline of Unresponsiveness Scale and the Glasgow Coma Scale in predicting discharge outcomes in patients with traumatic brain injuryMethod: A comparative research design conducted at Neurosurgery Intensive Care Unit in El Fayoum University Hospital. The Study recruited a purposive sample of 100 adult patients with TBI. They assessed using three tools (Patients Profile Data Form, Level of Consciousness Assessment," and Tool Discharge Data Assessment Record).Results: GCS is superior to FOUR score in prediction of length of stay and full recovery without any squeal while they are the same in the prediction of motor disability and sensory impairment (physical impairment). FOUR score is superior to GCS in the prediction of mortalityConclusion: the FOUR score provides more neurologic details than the GCS and is a valid predictor of outcome in patients with TBI; thus, it could be considered as a future prognostic model. It recommended for using FOUR score for predicting outcomes in patients with traumatic brain injuries as a valid predictor of discharge outcomes after traumatic brain injury.
34
Salah, Rania, Tamer Fakhri, and Ahmed Gaber. "Full outline of unresponsiveness versus Glasgow coma scale in predicting mortality in paediatric trauma patients." International Surgery Journal 6, no. 7 (June 29, 2019): 2279. http://dx.doi.org/10.18203/2349-2902.isj20192947.
Full textAbstract:
Background: Many scoring models have been proposed for evaluating level of consciousness in trauma patients. The aim of this study is to compare Glasgow coma scale (GCS) and full outline of unresponsiveness (FOUR) score in predicting the morbidity and mortality of trauma paediatric patients.Methods: In this diagnostic accuracy study trauma paediatric patients hospitalized in emergency room (ER) of Menoufia University hospital were evaluated. GCS and FOUR score of each patient were simultaneously calculated on admission as well as 6, 12 and 24 hours after that. The predictive values of the two scores and their area under the receiver operating characteristics (ROC) curve were compared.Results: 100 patients were included in the present study (mean age 7.6±5.1; 77% male). Comparing the area under the ROC curve of GCS and FOUR score showed that these values were not different at any of the evaluated times: on admission (p=0.68), and 6 hours (p=0.13), 12 hours (p=0.18). However, The values of FOUR score was high accuracy than GCS score in predicting mortality in paediatric patients with ROC; 0.97, 0.89 respectively.Conclusions: The results of our study showed that, GCS and FOUR score have the same value in predicting the mortality of trauma patients in first 24 hours. However, FOUR score has high accuracy than GCS score after 24 hours. Both tools had high predictive power in predicting the outcome at the time of discharge.
35
Cascarani, Giovanna Franchi, Enrico Affonso Barletta, and Daniela Prata Tacchelli. "Glasgow in Maxillofacial Fractures Patients: Mini Review." International Journal of Innovative Science and Research Technology 5, no. 6 (July 22, 2020): 1579–81. http://dx.doi.org/10.38124/ijisrt20jun933.
Full textAbstract:
Background: Maxillofacial traumas are the most frequent one, and are usually associated with brain injuries that can be measured by the Glasgow Coma Scale (GCS).Material and Methods: We did a mini review of the literature using PubMed as our data base, using “maxillofacial trauma and Glasgow Coma Scale” as key words. Among 73 articles found, we selected 3 articles that together analyzed 213 patients. Results: It was found that male patients (77,4%) were more affected than female (22,5%), the average age was 34,6 ±8,32 years, and the most common mechanism of trauma was vehicle accident. Just 10 patients presented a score between 14 and 15 on the GCS, which showed that most patients had neurological damage in different degrees.Conclusions: It was found that there is a relation between maxillofacial trauma and a decreased level of consciousness. Although, the literature lacks of studies analyzing the relation and presence of an altered mental status and the occurrence of a maxillofacial trauma.
36
Kochar, Amit, Meredith L. Borland, Natalie Phillips, Sarah Dalton, John Alexander Cheek, Jeremy Furyk, Jocelyn Neutze, et al. "Association of clinically important traumatic brain injury and Glasgow Coma Scale scores in children with head injury." Emergency Medicine Journal 37, no. 3 (February 12, 2020): 127–34. http://dx.doi.org/10.1136/emermed-2018-208154.
Full textAbstract:
ObjectiveHead injury (HI) is a common presentation to emergency departments (EDs). The risk of clinically important traumatic brain injury (ciTBI) is low. We describe the relationship between Glasgow Coma Scale (GCS) scores at presentation and risk of ciTBI.MethodsPlanned secondary analysis of a prospective observational study of children<18 years who presented with HIs of any severity at 10 Australian/New Zealand centres. We reviewed all cases of ciTBI, with ORs (Odds Ratio) and their 95% CIs (Confidence Interval) calculated for risk of ciTBI based on GCS score. We used receiver operating characteristic (ROC) curves to determine the ability of total GCS score to discriminate ciTBI, mortality and need for neurosurgery.ResultsOf 20 137 evaluable patients with HI, 280 (1.3%) sustained a ciTBI. 82 (29.3%) patients underwent neurosurgery and 13 (4.6%) died. The odds of ciTBI increased steadily with falling GCS. Compared with GCS 15, odds of ciTBI was 17.5 (95% CI 12.4 to 24.6) times higher for GCS 14, and 484.5 (95% CI 289.8 to 809.7) times higher for GCS 3. The area under the ROC curve for the association between GCS and ciTBI was 0.79 (95% CI 0.77 to 0.82), for GCS and mortality 0.91 (95% CI 0.82 to 0.99) and for GCS and neurosurgery 0.88 (95% CI 0.83 to 0.92).ConclusionsOutside clinical decision rules, decreasing levels of GCS are an important indicator for increasing risk of ciTBI, neurosurgery and death. The level of GCS should drive clinician decision-making in terms of urgency of neurosurgical consultation and possible transfer to a higher level of care.
37
Dewi, Rismala, Irawan Mangunatmadja, and Irene Yuniar. "Perbandingan Full Outline of Unresponsiveness Score dengan Glasgow Coma Scale dalam Menentukan Prognostik Pasien Sakit Kritis." Sari Pediatri 13, no. 3 (November 17, 2016): 215. http://dx.doi.org/10.14238/sp13.3.2011.215-20.
Full textAbstract:
Latar belakang. Penilaian kesadaran penting dilakukan pada pasien anak dengan sakit kritis untuk memperkirakanprognosis. Modifikasi Glasgow Coma Scale (GCS) banyak digunakan untuk menilai kesadaran tetapi memilikiketerbatasan terutama pada pasien yang diintubasi. Terdapat skor alternatif baru yaitu Full Outline ofUnResponsiveness score (FOUR score) yang dapat digunakan untuk menilai kesadaran pasien terintubasi.Tujuan. Membandingkan FOUR score dengan GCS dalam menentukan prognosis pasien kritis, sehinggapemeriksaan FOUR score dapat digunakan sebagai alternatif pengganti GCS.Metode. Penelitian prospektif observasional pada anak usia di bawah 18 tahun yang dirawat di Unit PerawatanIntensif Anak RSCM dengan penurunan kesadaran. Waktu penelitian antara 1 Januari – 31 Maret 2011.Masing-masing subjek dinilai oleh 3 orang supervisor berbeda yang bekerja di Unit Perawatan Intensif Anak.Ketiga penilai diuji reliabilitas dalam menilai FOUR score dan GCS. Dibandingkan sensitivitas, spesifisitas, danreceiver operating characteristic (ROC) kedua sistem skor terhadap luaran berupa kematian di rumah sakit.Hasil. Reliabilitas tiap pasangan untuk FOUR score (FOUR 0,963; 0,890; 0,845) lebih baik daripadamodifikasi GCS (GCS 0,851; 0,740; 0,700). Terdapat hubungan yang bermakna antara besar skor danluaran kematian di rumah sakit dengan (pFOUR score = pGCS = 0,001). Nilai sensitivitas, spesifisitas, nilai prediksipositif dan negatif serta rasio kemungkinan positif masing-masing adalah 93%; 86%; 88%; 92%; 6,6. Areaunder curve (AUC) FOUR score 0,854 dan GCS 0,808Kesimpulan. Prediksi prognostik pada pasien yang dirawat di Unit Perawatan Intensif Anak dengan FOURscore lebih baik dibandingkan GCS.
38
LNU, Mandeep, and Pravin Kumar. "Effectiveness of Early Intervention of Coma Arousal Therapy in Traumatic Head Injury Patients." International Journal of Head and Neck Surgery 3, no. 3 (2012): 137–42. http://dx.doi.org/10.5005/jp-journals-10001-1114.
Full textAbstract:
ABSTRACT Objective To find out efficacy and benefits of early intervention of coma arousal therapy on coma patients after sustaining traumatic head injury. Materials and methods Thirty comatose patients with traumatic head injury were systematic randomly selected. Both experimental group and control group were having 15 patients each. Patients in experimental group were given coma arousal therapy while those in control group did not receive any coma arousal therapy. Glasgow coma scale (GCS) and coma recovery scale (CRS) were assessed before and after 1 and 2 weeks protocol. Results The independent t-test was used for between the group data analysis. Repeated measure ANOVA and post hoc paired t-test were used in within the group analysis. Group A, mean of GCS on 1st, 7th and 14th day of coma arousal therapy was 3.93 (±1.09), 6.33 (±1.04) and 8.46 (±0.91) respectively and for Group B was 3.93 (±1.27), 4.80 (±1.26) and 5.93 (±1.94) respectively, which showed significant improvement (p < 0.05). Group A, mean of CRS on 1st, 7th and 14th day of coma arousal therapy was 2.06 (±1.03), 4.86 (±1.24) and 9.66 (±1.83) respectively and for Group B was 2.33 (±1.11), 2.93 (±1.09) and 4.73 (±2.18) respectively, which showed significant improvement (p < 0.05). When compared between the groups, experimental group showed significant improvement. Conclusion This is concluded from the result of this study that coma arousal therapy is having significant effect on GCS and CRS in traumatic head injury patients when compared to the patients who did not receive coma arousal therapy. How to cite this article Mandeep, Kumar P. Effectiveness of Early Intervention of Coma Arousal Therapy in Traumatic Head Injury Patients. Int J Head and Neck Surg 2012;3(3): 137-142.
39
Sah, SK, ND Subedi, K. Poudel, and M. Mallik. "Correlation of Computed Tomography findings with Glasgow Coma Scale in patients with acute traumatic brain injury." Journal of College of Medical Sciences-Nepal 10, no. 2 (July 13, 2015): 4–9. http://dx.doi.org/10.3126/jcmsn.v10i2.12947.
Full textAbstract:
OBJECTIVE To correlate Computed Tomography (CT) findings with Glasgow Coma Scale (GCS) in patients with acute traumatic brain injury attending in Chitwan Medical College teaching hospital Chitwan, Nepal.MATERIALS AND METHODS A cross-sectional study was performed among 50 patients of acute (less than24 hours) cases of craniocerebral trauma over a period of four months. The patient’s level of consciousness (GCS) was determined and a brain CT scan without contrast media was performed. A sixth generation General Electric (GE) CT scan was utilized and 5mm and 10mm sections were obtained for infratentorial and supratentorial parts respectively.RESULT The age range of the patients was 1 to 75 years (mean age 35.6± 21.516 years) and male: female ratio was 3.1:1. The most common causes of head injury were road traffic accident (RTA) (60%), fall injury (20%), physical assault (12%) and pedestrian injuries (8%). The distribution of patients in accordance with consciousness level was found to be 54% with mild TBI (GCS score 12 to 14), 28% with moderate TBI (GCS score 11 to 8) and 18% with severe TBI (GCS score less than 7). The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan was accompanied by lower GCS.CONCLUSION The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan were accompanied with lower GCS. Patients having single lesion had more GCS level than mixed level and mid line shift type of injury.Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2); 4-9
40
Agrawal, Basudev, and Rupesh Verma. "Correlation of Glasgow Coma Scale with Non-Contrast Computed Tomography findings in immediate post traumatic brain injury." International Journal of Research in Medical Sciences 7, no. 4 (March 27, 2019): 1059. http://dx.doi.org/10.18203/2320-6012.ijrms20191077.
Full textAbstract:
Background: This study was undertaken to correlate Glasgow Coma Scale (GCS) score with Non-Contrast Computed Tomography (NCCT) findings in patients with acute traumatic brain injury (TBI) attending tertiary care Shree Narayana Hospital, Raipur, Chhattisgarh, India.Methods: A cross-sectional study was performed among 100 patients of acute traumatic head injury (those presenting to hospital within 24 hours of injury) over a period of six months. The patient’s GCS score was determined and NCCT Brain scan was performed in each case immediately (within 30 minutes) after presenting to casualty of the hospital. A 16 slice siemens Somatom CT scan was utilized and 5mm and 10mm sections were obtained for infratentorial and supratentorial parts respectively.Results: The age range of the patients was 0 to 76 years and male: female ratio was 2.85:1. Younger age group was more commonly involved, with 61% of cases seen in 11-40 years of age group. The most common causes of head injury were road traffic accident (RTA) (65%) and fall from height (25%). The distribution of patients in accordance with GCS was found to be 55% with mild TBI (GCS 12 to 14), 25% with moderate TBI (GCS 11 to 8) and 20% with severe TBI (GCS 7 or less).Conclusions: The presence of multiple lesions and midline shift on CT scan were accompanied with lower GCS, whereas patients having single lesion had more GCS level. There was significant correlation between GCS and NCCT findings in immediate post TBI.
41
Dewi, Rismala. "Penilaian Kesadaran pada Anak Sakit Kritis: Glasgow Coma Scale atau Full Outline of UnResponsiveness score?" Sari Pediatri 17, no. 5 (July 12, 2016): 401. http://dx.doi.org/10.14238/sp17.5.2016.401-406.
Full textAbstract:
Pemeriksaan neurologis tingkat kesadaran sangat penting untuk menilai secara komprehensif pasien anak sakit kritis, dan dapat memberikan informasi prognosis. Skala koma yang ideal seharusnya bersifat linear, reliabel, valid, dan mudah digunakan. Berbagai macam skala koma telah dikembangkan dan di validasi untuk mengevaluasi tingkat kesadaran secara cepat, menilai beratnya penyakit dan prognosis terhadap morbiditas dan mortalitas. Glasgow Coma Scale (GCS) merupakan alat pemeriksaan tingkat kesadaran yang paling sering digunakan dan dijadikan baku emas saat memvalidasi skala koma yang baru. GCS mempunyai keterbatasan karena pasien yang terintubasi tidak dapat dinilai komponen verbal sehingga memengaruhi hasil penilaian. FOUR Score dikembangkan untuk mengatasi berbagai keterbatasan yang dimiliki GCS. FOUR score lebih sederhana dan memberikan informasi yang lebih baik, terutama pada pasien-pasien yang terintubasi.
42
Zappa, Sergio, Nazzareno Fagoni, Michele Bertoni, Claudio Selleri, Monica Aida Venturini, Paolo Finazzi, Marta Metelli, Frank Rasulo, Simone Piva, and Nicola Latronico. "Determination of Imminent Brain Death Using the Full Outline of Unresponsiveness Score and the Glasgow Coma Scale: A Prospective, Multicenter, Pilot Feasibility Study." Journal of Intensive Care Medicine 35, no. 2 (October 30, 2017): 203–7. http://dx.doi.org/10.1177/0885066617738714.
Full textAbstract:
Purpose: To evaluate the accuracy of the imminent brain death (IBD) diagnosis in predicting brain death (BD) by daily assessment of the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale (GCS) with the assessment of brain stem reflexes. Materials and Methods: Prospective multicenter pilot study carried out in 5 adult Italian intensive care units (ICUs). Imminent brain death was established when the FOUR score was 0 (IBD-FOUR) or the GCS score was 3 and at least 3 among pupillary light, corneal, pharyngeal, carinal, oculovestibular, and trigeminal reflexes were absent (IBD-GCS). Results: A total of 219 neurologic evaluations were performed in 40 patients with deep coma at ICU admission (median GCS 3). Twenty-six had a diagnosis of IBD-FOUR, 27 of IBD-GCS, 14 were declared BD, and 9 were organ donors. The mean interval between IBD diagnosis and BD was 1.7 days (standard deviation [SD] 2.0 days) using IBD-FOUR and 2.0 days (SD 1.96 days) using IBD-GCS. Both FOUR and GCS had 100% sensitivity and low specificity (FOUR: 53.8%; GCS: 50.0%) in predicting BD. Conclusions: Daily IBD evaluation in the ICU is feasible using FOUR and GCS with the assessment of brain stem reflexes. Both scales had 100% sensitivity in predicting IBD, but FOUR may be preferable since it incorporates the pupillary, corneal, and cough reflexes and spontaneous breathing that are easily assessed in the ICU.
43
Tesseris, J., N. Pantazidis, Cr Routsi, and D. Fragoulakis. "A comparative study of the Reaction Level Scale (RLS 85) with Glasgow Coma Scale (GCS) and Edinburgh-2 Coma Scale (modified) (E2CS(M))." Acta Neurochirurgica 110, no. 1-2 (March 1991): 65–76. http://dx.doi.org/10.1007/bf01402050.
Full text
44
Eizadi Mood, N., A. M. Sabzghabaee, Gh Yadegarfar, A. Yaraghi, and M. Ramazani Chaleshtori. "Glasgow Coma Scale and Its Components on Admission: Are They Valuable Prognostic Tools in Acute Mixed Drug Poisoning?" Critical Care Research and Practice 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/952956.
Full textAbstract:
Introduction. The verbal, eye, and motor components of Glasgow coma scale (GCS) may be influenced by poisoned patients' behavior in an attempted suicide. So, the values of admission GCS and its components for outcomes prediction in mixed drugs poisoning were investigated.Materials and Methods. A followup study data was performed on patients with mixed drugs poisoning. Outcomes were recorded as without complications and with complications. Discrimination was evaluated by calculating the area under the receiver operating characteristic curves (AUC).Results. There was a significant difference between the mean value of each component of GCS as well as the total GCS between patients with and without complication. Discrimination was best for GCS (AUC:0.933±0.020) and verbal (0.932±0.021), followed by motor (0.911±0.025), then eye (0.89±0.028).Conclusions. Admission GCS and its components seem to be valuable in outcome prediction of patients with mixed drug poisoning.
45
Sukorini, Usi, Isti Setijorini Wulandari, Budi Mulyono, and Handoyo Pramusinto. "KORELASI ANTARA NEURON-SPECIFIC ENOLASE SERUM DAN GLASGOW COMA SCALE DI PASIEN CEDERA KEPALA." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 17, no. 1 (March 26, 2018): 25. http://dx.doi.org/10.24293/ijcpml.v17i1.1043.
Full textAbstract:
The outcome after head injury is mostly determined by Glasgow Coma Scale (GCS) and the degree of brain damage which reveals.CT scan is also important to assess its severity. However relatively it is not in a less costly manner and sometimes patients mobilisationare needed. Brain damage due to traumatic head injury refers to homeostasis unbalance, and it is the important causes of releasingbiochemical analyte from neuron via injured blood brain barrier to circulation. Neuron-specific enolase as a glycolytic enzyme in neuroncytoplasm might increase. Hopefully, measurement of NSE levels can provide information about the extent of the disease. The objectiveof the study is to test the correlation between the Neuron Specific Enolase (NSE) serum as a one of biochemical marker of brain injuryand the GCS. For this purpose, a cross sectional, analytical observasional study was carried out at the Emergency Departement andDepartement of Clinical Laboratory, Sardjito General Hospital, Yogyakarta, Indonesia. Fifty-one patients selected by an eligible criteriawere included in the study, which consist of severe, moderate and mild head injury. Blood samples were collected and serum NSE wasmeasured by immunoanalyzer using Electro Cheluminescence ImmunoAssay (ECLIA). Chi square test was used to test the differenceproportion of the group: NSE ≥ 21.7 ng/mL and NSE < 21.7 ng/mL according to measured variables, and Spearman correlation testwas used to correlate serum NSE and GCS, and other variables. In the study fifty-one patients with head injury were included, 74.5%of patients were males and 68.6% is in the age of 15–45 years old. The patients were further divided into two groups on the basis ofserum NSE ≥ 21.7 ng/mL and < 21.7 ng/mL; the former group was dominated by severe head injury patients (54.1%). In addition, aproportion of non survivors (66.6%) in group NSE ≥ 21.7 ng/mL was higher compared to those in NSE < 21.7 ng/mL group. Moreover,a large number of mild head injury (95.45%) and survivors (83.33%) had lower serum NSE (< 21.7 ng/mL). In the study, was found anegative correlation between serum NSE and GCS (r = -0.552; p = 0.00). Also, serum NSE were inversely correlated with blood kaliumand hemoglobin (r = -0.162; p = 0.027 dan r = -0.376; p = 0.009), in contrast with leucocytes count (r = 0.485; p = 0.001). Theconclusion so far there was a negative correlation between serum NSE and GCS. It is suggested that neuron-specific enolase can be veryuseful as a biochemical marker in assesssing the severity of head injury. Therefore, it is nessessary to carry out the prognostic study toknow to what extent it can predicting the outcomes.
46
Ali, Muhammad, Vinod Kumar, Shafique Ahmed, Hina Iram, Sagheer Ahmed, and Rukhsana Abdul Sattar. "Mortality among organophosphate poisoning patients presenting with low Glasgow coma scale score at A Tertiary Care Hospital." Professional Medical Journal 27, no. 10 (October 10, 2020): 2187–92. http://dx.doi.org/10.29309/tpmj/2020.27.10.4383.
Full textAbstract:
This study is designed to assess the mortality in OPP patients with low GCS scores. Study Design: Cross Sectional study. Setting: Jinnah Postgraduate Medical Center. Period: From 1st February 2018 to 31st August 2018. Material & Methods: Included patients with low GCS, both genders and age of 18-60 years diagnosed with OPP. Their GCS was calculated and the outcome was determined in terms of mortality. Results: Out of 70 patients, the mean age was 35.2+16.5 years with the majority (62.9%) <30 years. 62.9% of these were males. Most (57.1%) of them presented after ingestion of <15mL of OP, 60% had the poisoning for >60 minutes, and the majority (74.3%) had taken it orally. When the GCS was computed, 81.40% had that of >5, while the mean came out to be 6.64 ±1.43. The mortality rate here was 17.10%. Conclusion: GCS toll can be a helpful and practical tool in assessing the mortality among the patients of OPP. However, because of the limited literature on the subject further studies are recommended to improve its validity.
47
Nayak, Ashok Kumar, Srikanta Das, and Prafullachandra Hoogar. "Full Outline of Unresponsiveness Score versus Glasgow Coma Scale in Assessing Patients with Isolated Traumatic Head Injury." Journal of Evidence Based Medicine and Healthcare 8, no. 16 (April 19, 2021): 1047–52. http://dx.doi.org/10.18410/jebmh/2021/202.
Full textAbstract:
BACKGROUND Traumatic head injury is one of the most common causes of mortality all over the world. Substantial initial assessment of head injury and its intensity in these patients is the primary goal for medical treatment. Hence, there is a necessity for a score better than GCS for the assessment of head injury patients. FOUR score, a new coma scale was published by Wijdicks in 2005. It included 4 components, motor response, eye response, brainstem reflex, and respiration. It precisely assesses the neurological activity as it includes the brain stem reflexes and eliminates the verbal component and identifies locked-in syndromes, temporal lobe herniations and third nerve dysfunctions which GCS fails to do so. We wanted to evaluate the correlation between FOUR score and GCS in evaluating the level of consciousness in patients with head injuries and evaluate the interobserver reliability of both the above-mentioned scores. METHODS This is an observational prospective study conducted on 92 patients with isolated traumatic head injury admitted to Department of General Surgery, VIMSAR, Burla, from November 2018 to October 2020. The parameters that were evaluated were clinical examination at the time of admission, were blood pressure (BP), temperature, pulse, and respiratory rate at the time of admission. Assessment of GCS and FOUR score at the time of admission, at 6 th hour, 24th hour and daily assessment till discharge. RESULTS A total of 92 isolated traumatic head injury patients were included in the study. Number of females (19.5 %) were significantly less when compared to males. The Pearson correlation coefficient between FOUR score and GCS was calculated to be 0.945, 0.962 and 0.951 respectively at the time of presentation, after 6 hours and isolated traumatic head injury. After 24 hours in patients with isolated traumatic head injury, Cohen’s weighted Kappa of GCS and FOUR score inter reliability was 0.956 and 0.985 respectively. Area under receiver operating characteristic curve (ROC) for GCS and FOUR score with Modified Rankins Score was 0.951 and 0.951. Area under ROC for mortality for GCS and FOUR score was 0.974 and 0.997 respectively. CONCLUSIONS As per our results, there is an excellent correlation between GCS and FOUR score in head injury patients. The FOUR score aims to overcome these shortcomings with a scale that is both simple to use and comprehensive in its overall neurologic assessment of the isolated traumatic head injury patients. FOUR score might prove to be a better tool to evaluate the consciousness of head injury patients and help in detection and stratification of these patients and in monitoring the efficiency of ongoing treatment. KEYWORDS Four Score, GCS, Head Injury
48
Islam, Mohammad Rafiqul, Md Shafiqul Kabir Khan, Md Mahfuzur Rahman, Moajjam Hossain Talukder, Md Rezaul Karim, and Abdus Salam. "Comparison of Glasgow Outcome Scale (GOS) and Glasgow Coma Scale (GCS) between Surgical and Conservative Management of Spontaneous Supratentorial Intracerebral Hemorrhage Patients: A Randomized Control Trial." Journal of Current and Advance Medical Research 5, no. 2 (June 20, 2018): 49–54. http://dx.doi.org/10.3329/jcamr.v5i2.37059.
Full textAbstract:
Background: Glasgow outcome scale (GOS) and Glasgow Coma Scale (GCS) were the important parameter for the proper management of spontaneous supratentorialintracerebral hemorrhage patients.Objective: The purpose of the present study was to compare the GOS and GCS between surgical and conservative management of spontaneous supratentorialintracerebral hemorrhage patients.Methodology: This randomized control trial was conducted in the Department of Neurosurgery at Dhaka Medical College and Hospital from January 2010 to October 2011 for a period of one year and ten months. All hypertensive patients with spontaneous supratentorial intracerebral hemorrhage who were admitted within 48 hours of stroke in Neurosurgery Department during the study period were considered as a study population. Patients underwent surgery was considered as group I and patients those who did not give the consent for operation were treated conservatively was considered as group II.Result: A total of 31 patients were enrolled in this study of which 14 patients underwent surgical evacuation and 17 patients were selected for conservative therapy. Significant positive correlation was found between the GCS score on admission and GOS at 30 days follow-up in surgery group (r=0.649; p<0.05). But a positive significant correlation (r=0.613; P=0.020) was between GCS follow up with GCS on admission in surgery patients and (r=0.575; P=0.016) in conservative group.Conclusion: In conclusion both GOS and GCS are essential during the management of surgical and conservative spontaneous supratentorialintracerebral hemorrhage patients.Journal of Current and Advance Medical Research 2018;5(2):49-54
49
Hsiao, Albert K., Stuart P. Michelson, and Jerris R. Hedges. "Emergent Intubation and CT Scan Pathology of Blunt Trauma Patients with Glasgow Coma Scale Scores of 3–13." Prehospital and Disaster Medicine 8, no. 3 (September 1993): 229–36. http://dx.doi.org/10.1017/s1049023x00040413.
Full textAbstract:
AbstractIntroduction:Widely accepted guidelines for use of pharmacologic agents for prehospital intubation have not been fully developed. Toward the goal of formulating specific guidelines, this study sought to determine how well the Glasgow Coma Scale (GCS) score stratifies the need for emergent intubation (within 30 minutes of emergency department arrival or in the prehospital setting).Methods:A one-year, retrospective review of the charts of blunt trauma patients with presumed head injury who presented to the emergency department of a Level 1 trauma center with a GCS score of ≤13 was performed. A total of 120 patients met the inclusion and exclusion criteria.Results:A significant number of patients presenting with a GCS score of ≤9 required emergent intubation. A significant minority of patients presenting with a GCS score of 10–13 required emergent intubation (20%) or had intracranial pathology on head CT scan (23%), and the majority of patients from this subgroup did not require subsequent intubation. Alcohol or substance intoxication and communication barriers such as deafness and language difficulties limited the clinical examination.Conclusion:Patients with a presenting GCS score of ≤9 represent candidates for the use of pharmacologic agents to facilitate aggressive airway control by well-trained and supervised emergency medical technicians (EMTs). Emergent intubation of patients with a GCS score of 10–13 is problematic. Patients with a presenting GCS score of 10–13 must be evaluated individually and closely monitored. In the emergency department, head CT scans coupled with serial evaluations generally are warranted to assess underlying pathology in patients with a presenting GCS score of 10–13.
50
Irvin, Charlene B., Susan Szpunar, Lauren A. Cindrich, Justin Walters, and Robert Sills. "Should Trauma Patients with a Glasgow Coma Scale Score of 3 Be Intubated Prior to Hospital Arrival?" Prehospital and Disaster Medicine 25, no. 6 (December 2010): 541–46. http://dx.doi.org/10.1017/s1049023x00008736.
Full textAbstract:
AbstractIntroduction:Previous studies of heterogeneous populations (Glasgow Coma Scale (GCS) scores <9) suggest that endotracheal intubaton of trauma patients prior to hospital arrival (i.e., prehospital intubated) is associated with an increased mortality compared to those patients not intubated in the pre-hospital setting. Deeply comatose patients (GCS = 3) represent a unique population of severely traumatized patients and may benefit from intubation in the prehospital setting. The objective of this study was to compare mortality rates of severely comatose patients (scene GCS = 3) with prehospital endotracheal intubation to those intubated at the hospital.Methods:Using the National Trauma Data Bank (V. 6.2), the following variables were analyzed retrospectively: (1) age; (2) injury type (blunt or penetrating); (3) Injury Severity Score (ISS); (4) scene GCS = 3 (scored prior to intubation/without sedation); (5) emergency department GCS score; (6) arrival emergency department intubation status; (7) first systolic blood pressure in the emergency department (>0); (8) discharge status (alive or dead); (9) Abbreviated Injury Scale Score (AIS); and (10) AIS body region.Results:Of the 10,948 patients analyzed, 23% (2,491/10,948) were endotracheally intubated in a prehospital setting. Mortality rate for those hospital intubated was 35% vs. 62% for those with prehospital intubation (p <0.0001); mean ISS scores 24.2 ±16.0 vs. 31.6 ±16.2, respectively (p <0.0001). Using logistic regression, controlling for first systolic blood pressure, ISS, emergency department GCS, age, and type of trauma, those with prehospital intubation were more likely to die (OR = 1.9, 95% CI = 1.7−2.2). For patients with only head AIS scores (no other body region injury, n = 1,504), logistic regression (controlling for all other variables) indicated that those with prehospital intubation were still more likely to die (OR = 2.0. 95% CI = 1.4−2.9).Conclusions:Prehospital endotracheal intubation is associated with an increased mortality in completely comatose trauma patients (GCS = 3). Although the exact reasons for this remain unclear, these results support other studies and suggest the need for future research and re-appraisal of current policies for prehospital intubation in these severely traumatized patients.