• Brain injury : [BI] · Jul 2003

    The relationship between pre-hospital and emergency department Glasgow coma scale scores.

    • Jeffrey J Bazarian, Melissa A Eirich, and Steven D Salhanick.
    • Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. jeff_bazarian@urmc.rochester.edu
    • Brain Inj. 2003 Jul 1;17(7):553-60.

    IntroductionPre-hospital GCS scores are used to make critical patient care decisions and to fill in gaps in hospital-based TBI surveillance, but they may not be accurate.ObjectiveTo determine the relationship between pre-hospital (EMS-GCS) and emergency physician GCS scores (ED-GCS).MethodsProspective observational study of 60 TBI patients with a field GCS of 8-13 and age > 18. ED-GCS, EMS-GCS, time of GCS and vitals signs were recorded.AnalysisSimple and multiple linear regression.ResultsThe median EMS-GCS was 13 and that for ED-GCS was 15. There was a significant linear relationship between ED-GCS and EMS-GCS (r = 0.45, p = 0.003). There was improvement in the prediction of ED-GCS when alcohol/drug use and age (but not time) were added to EMS-GCS.ConclusionEMS-GCS is usually two points lower than ED-GCS, but the correlation between them is strong and independent of the time between score determinations. These results could prevent unnecessary procedures based on the EMS-GCS and improve the accuracy of TBI surveillance.

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