• Enfermería intensiva · Jan 2014

    Observational Study

    [Interobserver reliability of the Glasgow coma scale in critically ill patients with neurological and/or neurosurgical disease].

    • M M Sánchez-Sánchez, R Sánchez-Izquierdo, E I Sánchez-Muñoz, I Martínez-Yegles, M P Fraile-Gamo, and S Arias-Rivera.
    • Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.
    • Enferm Intensiva. 2014 Jan 1;25(1):15-23.

    IntroductionThe Glasgow coma scale (GCS) is a common tool used for neurological assessment of critically ill patients. Despite its widespread use, the GCS has some limitations, as sometimes different observers may value differently the same response.ObjectiveTo evaluate the interobserver agreement, among intensive care nurses with a minimum of 3 years experience, both in the overall estimate of GCS and for each of its components.MethodsProspective observational study including 110 neurological and/or neurosurgical patients conducted in a critical care unit of 18 beds, from October 2010 until December 2012. Registered variables: Demographic characteristics, reason for admission, overall GCS and its components. The neurological evaluation was conducted by a minimum of 3 nurses. One of them applied an algorithm and consensual assessment technique and all, independently, valued response to stimuli. Interobserver agreement was measured using the intraclass correlation coefficient (ICC) for a confidence interval (CI) of 95%. The study was approved by the Ethics Committee for Clinical Trails.ResultsThe intraclass correlation coefficient (confident interval) for scale was: Overall GCS: 0.989 (0.985-0.992); ocular response: 0.981 (0.974-0.986); verbal response: 0.971 (0.960-0.979); motor response: 0.987 (0.982-0.991).ConclusionIn our cohort of patients we observed a high level of consistency in the application of both the GCS as in each of its components.Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

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