Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
Injury. 2011 Sep;42(9):940-4. doi: 10.1016/j.injury.2010.09.019. Epub 2010 Nov 9.
The Glasgow coma scale (GCS) score is used in the initial evaluation of patients with traumatic brain injury (TBI); however, the determination of an accurate score is not possible in all clinical situations. Our aim is to determine if the individual components of the GCS score, or combinations of them, are useful in predicting mortality in patients with TBI.
The components of the GCS score and the receiver-operating characteristic (ROC) curves were analyzed from 27,625 cases of TBI in Taiwan.
The relationship between the survival rate and certain eye (E), motor (M) and verbal (V) score combinations for GCS scores of 6, 11, 12 and 13 were statistically significant. The areas under ROC curve of E+V, M+V and M alone were 0.904, 0.903 and 0.900, respectively, representing the 3 most precise combinations for predicting mortality. The area under the ROC curve for the complete GCS score (E+M+V) was 0.885. Patients with lower E, M and V score respectively, and lower complete GCS scores had higher hazard of death than those with the highest scores.
The results of this study indicate that the 3 fundamental elements comprising the Glasgow coma scale, E, M, and V individually, and in certain combinations are predictive of the survival of TBI patients. This observation is clinically useful when evaluating TBI patients in whom a complete GCS score cannot be obtained.
格拉斯哥昏迷评分（GCS）用于创伤性脑损伤（TBI）患者的初步评估；然而，并非所有临床情况下都能确定准确的评分。我们的目的是确定 GCS 评分的各个组成部分或它们的组合是否有助于预测 TBI 患者的死亡率。
分析了来自台湾 27625 例 TBI 病例的 GCS 评分的组成部分和受试者工作特征（ROC）曲线。
生存率与 GCS 评分 6、11、12 和 13 的某些眼（E）、运动（M）和言语（V）评分组合之间存在统计学关系。E+V、M+V 和 M 单独的 ROC 曲线下面积分别为 0.904、0.903 和 0.900，代表预测死亡率最准确的 3 个组合。完整 GCS 评分（E+M+V）的 ROC 曲线下面积为 0.885。E、M 和 V 评分较低且完整 GCS 评分较低的患者死亡风险高于评分最高的患者。
本研究结果表明，格拉斯哥昏迷评分的 3 个基本要素，即 E、M 和 V，单独或组合使用可预测 TBI 患者的生存情况。当评估无法获得完整 GCS 评分的 TBI 患者时，这种观察结果在临床上很有用。
