Senapathi Tjokorda Gde Agung, Wiryana Made, Aribawa I Gusti Ngurah Mahaalit, Ryalino Christopher
Department of Anesthesiology and Intensive Care, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia.
Open Access Emerg Med. 2017 Apr 10;9:43-46. doi: 10.2147/OAEM.S130643. eCollection 2017.
Accuracy of consciousness level assessment is very important. It may determine and influence further clinical decisions, thus influences patients' outcomes. The widest method in determining the level of awareness is the Glasgow Coma Scale (GCS). Despite its common use, GCS scores obtained by one clinician may differ from others depending on their interpretations and past experience. One of the tools used to assess the level of consciousness objectively is bispectral index (BIS). The aim of this study was to identify the correlation between BIS and GCS score in patients with traumatic brain injury.
A total of 78 patients who were admitted to emergency room for traumatic brain injury were included in this study. One observer evaluated the GCS of all patients to minimize subjectivity. Another investigator then obtained the BIS values for each patient. Spear-man's rank correlation coefficient was used to determine whether GCS correlated with BIS value.
In 78 patients, the BIS was found to be significantly correlated with GCS (=0.744, <0.01). The BIS values increased with an increasing GCS. Mean BIS values of mild, moderate, and severe head injury were 88.1±5.6, 72.1±11.1, and 60.4±11.7, respectively.
In this study, a significant correlation existed between GCS and BIS. This finding suggests that BIS may be used for assessing GCS in patients with traumatic brain injury. However, the scatters of BIS values for any GCS level may limit the BIS in predicting GCS accurately.
意识水平评估的准确性非常重要。它可能决定并影响进一步的临床决策，进而影响患者的预后。确定意识水平最广泛使用的方法是格拉斯哥昏迷量表（GCS）。尽管其使用广泛，但不同临床医生获得的GCS评分可能因解读和既往经验的不同而有所差异。用于客观评估意识水平的工具之一是脑电双频指数（BIS）。本研究的目的是确定创伤性脑损伤患者BIS与GCS评分之间的相关性。
本研究纳入了78例因创伤性脑损伤入住急诊室的患者。由一名观察者评估所有患者的GCS以尽量减少主观性。然后另一名研究者获取每位患者的BIS值。采用Spearman等级相关系数来确定GCS是否与BIS值相关。
在78例患者中，发现BIS与GCS显著相关（=0.744，<0.01）。BIS值随GCS升高而增加。轻度、中度和重度颅脑损伤的平均BIS值分别为88.1±5.6、72.1±11.1和60.4±11.7。
在本研究中，GCS与BIS之间存在显著相关性。这一发现表明BIS可用于评估创伤性脑损伤患者的GCS。然而，任何GCS水平下BIS值的离散度可能会限制BIS准确预测GCS的能力。
