Does a prehospital Glasgow Coma Scale score predict pediatric outcomes? Pediatr Emerg Care 2012 Oct;28(10):1027-32
Date
10/02/2012Pubmed ID
23023472DOI
10.1097/PEC.0b013e31826cac31Scopus ID
2-s2.0-84867397419 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
BACKGROUND: Although the Glasgow Coma Scale (GCS) score is widely used by medical professionals to evaluate and predict neurological outcomes, studies using the prehospital (P) GCS score to predict neurological outcomes in children are few.
OBJECTIVE: The objective of this study was to determine the agreement between the P GCS score and the emergency department (ED) GCS score, and the association between P GCS score and outcomes at hospital discharge in pediatric patients 5 to 18 years of age.
METHODS: Medical record review of children 5 to 18 years old with traumatic brain injury (TBI) was conducted. Children with documented P and ED GCS scores were eligible for enrollment. The hospital records of each enrolled child were reviewed, and the Glasgow outcome score and the disability rating scale scores were calculated. Agreement between the P and ED GCS scores was calculated using χ (κ statistic).
RESULTS: One hundred eighty-five subjects were included. There was strong agreement between P and ED GCS scores (κ = +0.69; confidence interval, 0.57-0.81). The Glasgow outcome score category improved with improving GCS category. The median disability rating scale score was also similar for P and ED GCS scores and was higher with decreasing GCS.
CONCLUSIONS: Our data showed strong agreement between P and ED GCS scores. Also, there was strong association between P GCS scores and short-term outcomes in children with TBI. The results support the use of GCS in prehospital transport destination guidelines for children with TBI.
Author List
Nesiama JA, Pirallo RG, Lerner EB, Hennes HMESH terms used to index this publication - Major topics in bold
AdolescentBrain Injuries
Child
Child, Preschool
Confidence Intervals
Emergency Service, Hospital
Female
Glasgow Coma Scale
Humans
Incidence
Male
Patient Discharge
ROC Curve
Retrospective Studies
Trauma Centers
Wisconsin
