Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development.
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo.
J Epidemiol. 2023 Oct 5;33(10):531-535. doi: 10.2188/jea.JE20220147. Epub 2022 Dec 23.
The Japan Coma Scale (JCS) is the most frequently adopted method for evaluating level of consciousness in Japan. However, no validated method for converting the JCS to the Glasgow Coma Scale (GCS) exists. The aims of the present study were to develop and validate a method to convert the JCS to GCS.
This is a multicenter retrospective analysis involving three emergency departments (EDs) in Japan. We included all adult patients who visited the ED between 2017 and 2020. The participating facilities were divided into two cohorts-one cohort to develop a table to convert the JCS to GCS (development cohort), and the other cohort to validate the conversion table (validation cohort). The conversion table of the JCS to GCS was developed based on the median values of the GCS. The outcome was the concordance rate between the JCS and GCS.
We identified 8,194 eligible patients. The development cohort included 7,373 patients and the validation cohort included 821 patients. In the validation cohort, the absolute and relative concordance rates were 80.3% (95% confidence interval, 77.4-82.9%) and 93.2% (95% confidence interval, 91.2-94.8%), respectively.
This study developed and validated a novel method for converting the JCS to GCS. Assuming the offset by a single category between the JCS and GCS is acceptable, the concordance rate was over 90% in the general adult patient population visiting the ED. The conversion method may assist researchers to convert JCS scores into GCS scores, which are more commonly recognized among global audiences.
日本昏迷评分（JCS）是评估日本意识水平最常用的方法。然而，目前还没有将 JCS 转换为格拉斯哥昏迷评分（GCS）的验证方法。本研究的目的是开发和验证一种将 JCS 转换为 GCS 的方法。
这是一项涉及日本 3 个急诊科（ED）的多中心回顾性分析。我们纳入了 2017 年至 2020 年间在 ED 就诊的所有成年患者。参与的医疗机构分为两个队列，一个队列用于开发将 JCS 转换为 GCS 的表格（开发队列），另一个队列用于验证转换表格（验证队列）。基于 GCS 的中位数，制定 JCS 到 GCS 的转换表格。结局为 JCS 和 GCS 的一致性率。
我们确定了 8194 名符合条件的患者。开发队列包括 7373 名患者，验证队列包括 821 名患者。在验证队列中，绝对和相对一致性率分别为 80.3%（95%置信区间，77.4%-82.9%）和 93.2%（95%置信区间，91.2%-94.8%）。
本研究开发并验证了一种将 JCS 转换为 GCS 的新方法。假设 JCS 和 GCS 之间的类别差异为 1 个是可以接受的，那么在访问 ED 的一般成年患者人群中，一致性率超过 90%。该转换方法可能有助于研究人员将 JCS 评分转换为 GCS 评分，这在全球范围内更为人所接受。
