院前与急诊科格拉斯哥昏迷量表评分之间的关系。
The relationship between pre-hospital and emergency department Glasgow coma scale scores.
作者信息
Bazarian Jeffrey J, Eirich Melissa A, Salhanick Steven D
机构信息
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
出版信息
Brain Inj. 2003 Jul;17(7):553-60. doi: 10.1080/0269905031000070260.
INTRODUCTION
Pre-hospital GCS scores are used to make critical patient care decisions and to fill in gaps in hospital-based TBI surveillance, but they may not be accurate.
OBJECTIVE
To determine the relationship between pre-hospital (EMS-GCS) and emergency physician GCS scores (ED-GCS).
METHODS
Prospective observational study of 60 TBI patients with a field GCS of 8-13 and age > 18. ED-GCS, EMS-GCS, time of GCS and vitals signs were recorded.
ANALYSIS
Simple and multiple linear regression.
RESULTS
The median EMS-GCS was 13 and that for ED-GCS was 15. There was a significant linear relationship between ED-GCS and EMS-GCS (r = 0.45, p = 0.003). There was improvement in the prediction of ED-GCS when alcohol/drug use and age (but not time) were added to EMS-GCS.
CONCLUSION
EMS-GCS is usually two points lower than ED-GCS, but the correlation between them is strong and independent of the time between score determinations. These results could prevent unnecessary procedures based on the EMS-GCS and improve the accuracy of TBI surveillance.
引言
院前格拉斯哥昏迷评分（GCS）用于做出关键的患者护理决策，并填补基于医院的创伤性脑损伤（TBI）监测中的空白，但它们可能并不准确。
目的
确定院前（急救医疗服务GCS，EMS-GCS）与急诊医生GCS评分（急诊室GCS，ED-GCS）之间的关系。
方法
对60例现场GCS评分为8 - 13且年龄大于18岁的TBI患者进行前瞻性观察研究。记录ED-GCS、EMS-GCS、GCS评分时间和生命体征。
分析
简单和多元线性回归。
结果
EMS-GCS的中位数为13，ED-GCS的中位数为15。ED-GCS与EMS-GCS之间存在显著的线性关系（r = 0.45，p = 0.003）。当将酒精/药物使用情况和年龄（而非时间）加入到EMS-GCS中时，ED-GCS的预测有所改善。
结论
EMS-GCS通常比ED-GCS低两分，但它们之间的相关性很强，且与两次评分测定之间的时间无关。这些结果可以避免基于EMS-GCS进行不必要的操作，并提高TBI监测的准确性。
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