Comparison of the prognostic validity of three simplified consciousness assessment scales with the Glasgow Coma Scale.
Background: Various tools simpler than the Glasgow Coma Scale (GCS) have been proposed for the assessment of consciousness. In this study, the validity of three coma scales [Simplified Motor Scale, Modified GCS Motor Response, and AVPU (alert, verbal, painful, unresponsive)] is evaluated for the rec...
| Published in: | European Journal of Trauma & Emergency Surgery Vol. 49; no. 5; pp. 2193 - 2203 |
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| Main Authors: | , , |
| Format: | research tables/charts Journal Article |
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Springer Nature
Oct2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=172329424&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 172329424 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Oct2023 vid: 49 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 172329424 164175228 172329424 172329424 10.1007/s00068-023-02286-w 172329424 ppf: 2193 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Comparison of the prognostic validity of three simplified consciousness assessment scales with the Glasgow Coma Scale. aug: au: Anestis, Dimitrios M. Marinos, Konstantinos Tsitsopoulos, Parmenion P. affil: https://ror.org/05v5wwy67 Department of Neurosurgery, Hippokration General Hospital, Aristotle University School of Medicine, 49 Konstantinoupoleos str., 54642, Thessaloníki, Greece sug: subj: Instrument Validation Scales Coma Diagnosis Consciousness Evaluation Glasgow Coma Scale Predictive Validity Coma Prognosis Coma Mortality Hospital Mortality Outcome Assessment Human Validation Studies Prospective Studies Nonexperimental Studies ROC Curve Greece Hospitalization Comatose Patients Male Female Adolescence Adult Middle Age Aged Aged, 80 and Over Descriptive Statistics Post Hoc Analysis Intensive Care Units Length of Stay Data Analysis Software Confidence Intervals Sensitivity and Specificity Emergency Patients Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: Various tools simpler than the Glasgow Coma Scale (GCS) have been proposed for the assessment of consciousness. In this study, the validity of three coma scales [Simplified Motor Scale, Modified GCS Motor Response, and AVPU (alert, verbal, painful, unresponsive)] is evaluated for the recognition of coma and the prediction of short- and long-term mortality and poor outcome. The predictive validity of these scales is also compared to the GCS. Methods: Patients treated in the Department of Neurosurgery and the Intensive Care Unit in need of consciousness monitoring were assessed by four raters (two consultants, a resident and a nurse) using the GCS. The corresponding values of the simplified scales were estimated. Outcome was recorded at discharge and at 6 months. Areas Under the Receiver Operating Characteristic Curve (AUCs) were calculated for the prediction of mortality and poor outcome, and the identification of coma. Results: Eighty-six patients were included. The simplified scales showed good overall validity (AUCs > 0.720 for all outcomes of interest), but lower than the GCS. For the identification of coma and the prediction of long-term poor outcome, the difference was significant (p < 0.050) for all the ratings of the most experienced rater. The validity of these scales was comparable to the GCS only in predicting in-hospital mortality, but without this being consistent for all raters. Conclusion: The simplified scales showed inferior validity than the GCS. Their potential role in clinical practice needs further investigation. Thus, the replacement of the GCS as the main scale for consciousness assessment cannot be currently supported. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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