Buechler C M, Blostein P A, Koestner A, Hurt K, Schaars M, McKernan J
Bronson Methodist Hospital, Kalamazoo, MI 49007, USA.
J Trauma. 1998 Sep;45(3):429-32. doi: 10.1097/00005373-199809000-00001.
Glasgow Coma Scale (GCS) scoring is enigmatic in intubated patients. To determine if there is consensus among Level I trauma centers, a national telephone survey was conducted.
Trauma registrars at state-verified or American College of Surgeons-verified Level I trauma centers were questioned about GCS scoring, recording, and reporting in patients who are intubated or intubated and pharmacologically paralyzed.
Seventy-three centers were contacted. Seventy-one use initial GCS scores for registry recording. Intubated patients are given 1 point for verbal component plus eye and motor scores at 26% of centers and a total GCS score of 3 at 23%; GCS score is estimated with "T" given for verbal component at 16%, scored as unknown at 10%, always scored as 15 at 10%, and the method of scoring is unknown at 15%. Pharmacologically paralyzed intubated patients are given a total GCS score of 3 at 34%, GCS score is estimated with "T" given for verbal component at 18%, patients are given 1 point for verbal component plus eye and motor scores at 12%, scored as unknown at 11%, always scored as 15 at 8%, and the method of scoring is unknown at 16%.
Wide variation in GCS scoring among Level I trauma centers was identified. Because GCS scores are used in treatment algorithms, trauma scoring, and outcome prediction (Trauma and Injury Severity Score), uniform scoring is essential and should be pursued. Use of state and national databases and outcome research may be adversely affected by the lack of consistent GCS scoring.
格拉斯哥昏迷量表（GCS）评分在插管患者中存在难以理解的情况。为了确定一级创伤中心之间是否存在共识，开展了一项全国性电话调查。
对经州政府或美国外科医师学会认证的一级创伤中心的创伤登记员，就插管或插管且使用药物麻痹的患者的GCS评分、记录和报告情况进行询问。
联系了73个中心。71个中心在登记记录中使用初始GCS评分。26%的中心对插管患者的言语部分给予1分，加上眼睛和运动评分；23%的中心给予的GCS总分是3分；16%的中心用“T”表示言语部分来估计GCS评分；10%的中心将其记为未知；10%的中心总是记为15分；15%的中心评分方法未知。34%的中心对使用药物麻痹的插管患者给予的GCS总分是3分；18%的中心用“T”表示言语部分来估计GCS评分；12%的中心对患者的言语部分给予1分，加上眼睛和运动评分；11%的中心记为未知；8%的中心总是记为15分；16%的中心评分方法未知。
一级创伤中心之间的GCS评分存在很大差异。由于GCS评分用于治疗方案、创伤评分和预后预测（创伤和损伤严重程度评分），统一评分至关重要，应予以推行。缺乏一致的GCS评分可能会对州和国家数据库的使用以及预后研究产生不利影响。
