Does a prehospital glasgow coma scale score predict pediatric outcomes?

Jo Ann O Nesiama, Ronald G. Pirallo, E. Brooke Lerner, Halim Hennes

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1027-1032
Number of pages6
JournalPediatric Emergency Care
Volume28
Issue number10
DOIs
StatePublished - Oct 1 2012

Keywords

  • Glasgow Coma Scale score
  • Glasgow outcome score
  • disability rating scale
  • prehospital

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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