Nayebaghayee Hossein, Afsharian Tahmineh
Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Asian J Neurosurg. 2016 Jan-Mar;11(1):46-9. doi: 10.4103/1793-5482.165780.
The study aimed to assess the relationship between computed tomography (CT) scan findings and Glasgow Coma Scale (GCS) score with the purpose of introducing GCS scoring system as an acceptable alternative for CT scan to clinically management of brain injuries in head trauma patients.
This study was conducted on hospitalized patients with the complaints of head trauma. The severity of the head injury was assessed on admission by the GCS score and categorized as mild, moderate, or severe head injury.
Of all study subjects, 80.5% had GCS 13-15 that among those, 45% had GCS 15. Furthermore, 10.5% had GCS ranged 9-12 and 9% had GCS <8. Of all subjects, 54.5% had abnormal CT findings that of them, 77.1% categorized as mild head injury, 11.0% had a moderate head injury, and 11.9% had a severe head injury. Furthermore, of those with GCS 15, 41.0% had abnormal CT scan. Of all patients with abnormal CT findings, 33.0% underwent surgery that 61.1% categorized in mild head injury group, 13.9% categorized in moderate head injury group, and 22.2% categorized in severe head injury group. Of those with GCS equal to 15, only 27.0% underwent surgery.
The use of GCS score for assessing the level of injury may not be sufficient and thus considering CT findings as the gold standard, the combination of this scoring system and other applicable scoring systems may be more applicable to stratify brain injury level.
本研究旨在评估计算机断层扫描(CT)结果与格拉斯哥昏迷量表(GCS)评分之间的关系,目的是引入GCS评分系统作为CT扫描的可接受替代方法,用于头部创伤患者脑损伤的临床管理。
本研究针对因头部创伤入院的患者进行。入院时通过GCS评分评估头部损伤的严重程度,并分为轻度、中度或重度头部损伤。
在所有研究对象中,80.5%的患者GCS评分为13 - 15分,其中45%的患者GCS评分为15分。此外,10.5%的患者GCS评分为9 - 12分,9%的患者GCS评分<8分。在所有研究对象中,54.5%的患者CT检查结果异常,其中77.1%被归类为轻度头部损伤,11.0%为中度头部损伤,11.9%为重度头部损伤。此外,GCS评分为15分的患者中,41.0%的患者CT扫描结果异常。在所有CT检查结果异常的患者中,33.0%接受了手术,其中61.1%属于轻度头部损伤组,13.9%属于中度头部损伤组,22.2%属于重度头部损伤组。在GCS评分为15分的患者中,只有27.0%接受了手术。
使用GCS评分评估损伤程度可能不够充分,因此以CT检查结果作为金标准,将该评分系统与其他适用的评分系统相结合可能更适用于对脑损伤程度进行分层。