Evaluation of Coma: A Critical Appraisal of Popular Scoring Systems

被引:61
作者
Kornbluth, Joshua [1 ]
Bhardwaj, Anish [1 ]
机构
[1] Tufts Univ, Sch Med, Dept Neurol, Boston, MA 02111 USA
关键词
Coma; GCS; FOUR score; RLS85; Consciousness; REACTION-LEVEL-SCALE; INTENSIVE-CARE-UNIT; LINEAR-REGRESSION PREDICTION; BRAIN-INJURY OUTCOMES; GLASGOW VERBAL SCORE; EMERGENCY-DEPARTMENT; CARDIAC-ARREST; IMPAIRED CONSCIOUSNESS; ACUTE PHYSIOLOGY; MOTOR SCORE;
D O I
10.1007/s12028-010-9409-3
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Numerous scoring scales have been proposed and validated to evaluate coma for rapid pre-hospital assessment and triage, disease severity, and prognosis for morbidity and mortality. These scoring systems have been predicated on core features that serve as a basis for this review and include ease of use, inter-rater reliability, reproducibility, and predictive value. Here we review the benefits and limitations of the most popular coma scoring systems. The methods include search of Medline, databases, and manual review of article bibliographies. Few of the many available coma scales have gained widespread approval and popularity. The best known and widely accepted scale is the Glasgow Coma Scale (GCS). The Reaction Level Scale (RLS85) has utility and proven benefit, but little acceptance outside of Scandinavia. The newer Full Outline of UnResponsiveness (FOUR) score provides an attractive replacement for all patients with fluctuating levels of consciousness and is gradually gaining wide acceptance.
引用
收藏
页码:134 / 143
页数:10
相关论文
共 89 条
[51]   FIELD TRIAGE OF TRAUMA PATIENTS BASED UPON THE ABILITY TO FOLLOW COMMANDS - A STUDY IN 29,573 INJURED PATIENTS [J].
MEREDITH, W ;
RUTLEDGE, R ;
HANSEN, AR ;
OLLER, DW ;
THOMASON, M ;
CUNNINGHAM, P ;
BAKER, CC .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1995, 38 (01) :129-135
[52]   COMA SCALE FOR USE IN BRAIN-INJURED CHILDREN [J].
MORRAY, JP ;
TYLER, DC ;
JONES, TK ;
STUNTZ, JT ;
LEMIRE, RJ .
CRITICAL CARE MEDICINE, 1984, 12 (12) :1018-1020
[53]   RELATION BETWEEN GLASGOW COMA SCORE AND COUGH REFLEX [J].
MOULTON, C ;
PENNYCOOK, AG .
LANCET, 1994, 343 (8908) :1261-1262
[54]  
MULLIE A, 1988, LANCET, V1, P137
[55]   ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION (APACHE II) AND GLASGOW COMA SCORES AS PREDICTORS OF OUTCOME FROM INTENSIVE-CARE AFTER CARDIAC-ARREST [J].
NISKANEN, M ;
KARI, A ;
NIKKI, P ;
IISALO, E ;
KAUKINEN, L ;
RAUHALA, V ;
SAARELA, E ;
HALINEN, M .
CRITICAL CARE MEDICINE, 1991, 19 (12) :1465-1473
[56]   A prehospital Glasgow Coma Scale score ≤ 14 accurately predicts the need for full trauma team activation and patient hospitalization after motor vehicle collisions [J].
Norwood, SH ;
McAuley, CE ;
Berne, JD ;
Vallina, VL ;
Creath, RG ;
McLarty, J .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2002, 53 (03) :503-507
[57]   A new subarachnoid hemorrhage grading system based on the Glasgow Coma Scale: A comparison with the Hunt and Hess and World Federation of Neurological Surgeons Scales in a clinical series [J].
Oshiro, EM ;
Walter, KA ;
Piantadosi, S ;
Witham, TF ;
Tamargo, RJ .
NEUROSURGERY, 1997, 41 (01) :140-147
[58]   Comparison of the three strategies of verbal scoring of the Glasgow Coma Scale in patients with stroke [J].
Prasad, K ;
Menon, GR .
CEREBROVASCULAR DISEASES, 1998, 8 (02) :79-85
[59]   Subarachnoid hemorrhage grading scales - A systematic review [J].
Rosen, DS ;
Macdonald, RL .
NEUROCRITICAL CARE, 2005, 2 (02) :110-118
[60]   Increased serum levels of the S-100 protein are associated with hypoxic brain damage after cardiac arrest [J].
Rosén, H ;
Rosengren, L ;
Herlitz, J ;
Blomstrand, C .
STROKE, 1998, 29 (02) :473-477