Teasdale G M, Pettigrew L E, Wilson J T, Murray G, Jennett B
Department of Neurosurgery, University of Glasgow, United Kingdom.
J Neurotrauma. 1998 Aug;15(8):587-97. doi: 10.1089/neu.1998.15.587.
The Glasgow Outcome Scale (GOS), two decades after its description, remains the most widely used method of analyzing outcome in series of severely head-injured patients. This review considers limitations recognized in the use of the GOS and discusses a new approach to assessment, using a structured questionnaire-based interview. Assignments can be made to an extended eight-point scale (GOSE) as well as the original five-point approach-in each case, with a high degree of interobserver consistency. The assignments are coherent with the principles of the World Health Organization classification of impairments, disabilities, and handicaps, and their validity is supported by strong associations with the results of neuropsychological testing and assessment of general health status. The need to allow for disability existing before injury, issues concerning the time of assessment after injury, and subdivisions of the scale into "favorable" and "unfavorable" categories are discussed. It is concluded that, in its improved structured format, the Glasgow Outcome Scale should remain the primary method of assessing outcome in trials of the management of severe head injury.
格拉斯哥预后量表（GOS）自问世二十年来，仍是分析重度颅脑损伤患者系列预后最广泛使用的方法。本综述考虑了GOS使用中公认的局限性，并讨论了一种基于结构化问卷访谈的新评估方法。可将结果归类为扩展的八点量表（GOSE）以及原始的五点量表——在每种情况下，观察者间的一致性都很高。这些归类与世界卫生组织对损伤、残疾和残障的分类原则相一致，并且其有效性得到了与神经心理学测试结果及总体健康状况评估之间的强关联的支持。文中还讨论了考虑受伤前存在的残疾的必要性、受伤后评估时间的相关问题以及将量表细分为“良好”和“不良”类别的问题。得出的结论是，以其改进后的结构化形式，格拉斯哥预后量表应仍然是重度颅脑损伤治疗试验中评估预后的主要方法。
