Temkin Nancy, Barber Jason, Machamer Joan, Sugar Gabriela, Morrissey Molly Rose, Boase Kim, Zahniser Evan, Bodien Yelena G, Giacino Joseph T, McCrea Michael A, Nelson Lindsay D, Stein Murray B, Taylor Sabrina, Robertson Claudia, Okonkwo David, Manley Geoff, Dikmen Sureyya
Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
Department of Biostatistics, University of Washington, Seattle, Washington, USA.
J Neurotrauma. 2025 Apr 9. doi: 10.1089/neu.2024.0421.
The Glasgow Outcome Scale Extended (GOSE) is the most widely used outcome measure for hospital-based studies of traumatic brain injury (TBI). The GOSE may be administered several ways, the choice depending on the purpose of the research. In this investigation, we evaluated the effect of administering the GOSE to collect functional disability attributed to all injuries sustained (GOSE-All) or excluding the impact of extracranial injuries (GOSE-TBI). We examined the differences in reported disability between the two administration methods at 2 weeks, 3 months, 6 months, and 12 months after injury. Data are summarized from 2288 individuals who were enrolled in the prospective observational Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) cohort study. The distribution of scores is summarized by time after injury, brain injury severity, and extracranial injury severity. Dichotomizing the GOSE varying ways, differences in the prevalence of unfavorable outcomes for GOSE-All versus GOSE-TBI range from none to 42 percentage points. Discrepancies in disability captured by GOSE-All and GOSE-TBI decrease with greater TBI severity, no serious extracranial injuries, and longer time post-injury. It is important for researchers, given the aims of their studies, to decide in advance whether GOSE classification should be based on the effects of all injuries sustained or excluding the effects of extracranial injuries so as to emphasize the effects of the brain injury, as well as how disability due to emotional consequences of injury and other circumstances will be scored. Instructions to the respondent and outcomes examiner need to be clear about what causes of disability are to be included. The TBI Common Data Elements should include information that reflects the method that was used to collect the GOSE data and data repositories should disclose which data collection method was used for a given study.
格拉斯哥扩展预后量表（GOSE）是用于创伤性脑损伤（TBI）医院研究中使用最广泛的预后测量方法。GOSE可以通过多种方式进行评估，具体选择取决于研究目的。在本研究中，我们评估了采用GOSE来收集所有损伤导致的功能残疾（GOSE-All）或排除颅外损伤影响（GOSE-TBI）的效果。我们研究了受伤后2周、3个月、6个月和12个月时两种评估方法报告的残疾差异。数据总结自2288名纳入前瞻性观察性创伤性脑损伤转化研究与临床知识（TRACK-TBI）队列研究的个体。分数分布按受伤时间、脑损伤严重程度和颅外损伤严重程度进行总结。将GOSE以不同方式进行二分法分析，GOSE-All与GOSE-TBI不良预后患病率的差异范围从无差异到42个百分点。随着TBI严重程度增加、无严重颅外损伤以及受伤后时间延长，GOSE-All和GOSE-TBI所反映的残疾差异减小。对于研究人员而言，根据其研究目的提前决定GOSE分类是应基于所有损伤的影响还是排除颅外损伤的影响，以便强调脑损伤的影响，以及如何对因损伤的情感后果和其他情况导致的残疾进行评分非常重要。向受访者和结果评估者的说明需要明确应包括哪些残疾原因。TBI通用数据元素应包括反映用于收集GOSE数据的方法的信息，并且数据存储库应披露给定研究使用了哪种数据收集方法。
