Seno Soichiro, Aoki Makoto, Kiyozumi Tetsuro, Wada Kojiro, Tomura Satoshi
Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Japan.
Division of Traumatology, Research Institute, National Defense Medical College, Tokorozawa, Japan.
Neurotrauma Rep. 2024 Sep 26;5(1):883-889. doi: 10.1089/neur.2024.0096. eCollection 2024.
The Glasgow Coma Scale (GCS) is the most commonly used consciousness rating scale worldwide. Although it is a sensitive and accurate way of assessing a patient's level of consciousness, it is time-consuming and requires training. We designed the Simple Coma Scale (SCS) as a simplified version of the GCS. In this study, we examined whether the SCS could predict favorable neurogenic outcomes at discharge, survival, and GCS scores in patients with traumatic brain injury (TBI). We analyzed the data of 1,230 patients registered in the Japan Neurotrauma Data Bank (Project 2015) between April 2015 and March 2017. In the SCS, eye, verbal, and motor scores are given based on a 3-point scoring system, with similar wording ("Normal," "Something Wrong," and "None") used for all scores. The SCS is based on a 7-point scale. The Glasgow Outcome Scale was used to assess the outcomes. For the receiver operating characteristic (ROC) curves with the objective variable of good prognosis at discharge in the SCS and GCS, the area under the curve (AUC) for the SCS was 0.740 (95% confidence interval [CI]: 0.711-0.769), and that of the GCS was 0.757 (95% CI: 0.729-0.786). For ROC curves with survival as the objective variable, the AUC of the SCS was 0.751 (95% CI: 0.724-0.778), and that of the GCS was 0.764 (95% CI: 0.737-0.791). The SCS, similar to the GCS, may predict good prognosis and survival at discharge. Further analyses will continue to examine the usefulness and practicality of the SCS.
格拉斯哥昏迷量表（GCS）是全球最常用的意识评分量表。尽管它是评估患者意识水平的一种敏感且准确的方法，但耗时且需要培训。我们设计了简易昏迷量表（SCS）作为GCS的简化版本。在本研究中，我们探讨了SCS能否预测创伤性脑损伤（TBI）患者出院时良好的神经源性结局、生存率及GCS评分。我们分析了2015年4月至2017年3月在日本神经创伤数据库（2015项目）中登记的1230例患者的数据。在SCS中，眼、言语和运动评分基于三分制评分系统，所有评分使用相似的措辞（“正常”“有问题”和“无”）。SCS基于七分制。使用格拉斯哥结局量表评估结局。对于以SCS和GCS出院时预后良好为客观变量的受试者工作特征（ROC）曲线，SCS的曲线下面积（AUC）为0.740（95%置信区间[CI]：0.711 - 0.769），GCS的为 0.757（95% CI：0.729 - 0.786）。对于以生存为客观变量的ROC曲线，SCS的AUC为0.751（95% CI：0.724 - 0.778），GCS的为0.764（95% CI：0.737 - 0.791）。与GCS相似，SCS可能预测出院时的良好预后和生存率。进一步分析将继续探讨SCS的实用性和实际应用价值。
