Diagnosing Level of Consciousness: The Limits of the Glasgow Coma Scale Total Score

ABSTRACT:A retrospective study of 100 patients with spontaneous intracerebral haemorrhage was carried out, to identify clinical factors which have a predictive value for outcome. Numerical equivalents for the admission level of consciousness (the Glasgow Coma Scale), ventricular rupture, partial pressure of oxygen in the blood, the electrocardiogram, clot location, and clot size were combined into equations predicting outcome. The best single parameter for prediction was the Glasgow Coma Scale.

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Assessment of level of consciousness following severe neurological insult

Journal of Neurosurgery ◽

10.3171/jns.1984.60.5.0955 ◽

1984 ◽

Vol 60 (5) ◽

pp. 955-960 ◽

Cited By ~ 64

Author(s):

Daniel E. Stanczak ◽

James G. White ◽

William D. Gouview ◽

Kurt A. Moehle ◽

Michael Daniel ◽

...

Keyword(s):

Glasgow Coma Scale ◽

Short Term ◽

Term Outcome ◽

Content Type ◽

Coma Scale ◽

Short Term Outcome ◽

Level Of Consciousness ◽

Comprehensive Level ◽

Neurological Insult ◽

Fine Print

✓ An alternative method of coma assessment is presented and compared with the Glasgow Coma Scale. The merits of the Comprehensive Level of Consciousness Scale as a research tool are presented. An analysis of 101 consecutive consciousness-impaired patients with their short-term outcome is presented.

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Correlation of Glasgow Coma Scale Score at Hospital Admission with Stroke Hemorrhagic Patient Mortality at Hasan Sadikin Hospital

Journal Of Medicine & Health ◽

10.28932/jmh.v2i4.1139 ◽

2019 ◽

Vol 2 (4) ◽

Author(s):

Ary Setio Hartanto ◽

Andi Basuki ◽

Cep Juli

Keyword(s):

Glasgow Coma Scale ◽

Hospital Admission ◽

Hemorrhagic Stroke ◽

P Value ◽

Stroke Patients ◽

Coma Scale ◽

Risk Of Death ◽

Increased Risk ◽

Level Of Consciousness ◽

Gcs Score

Stroke is the most common cause of death in Indonesia. Stroke is divided into ischemic and hemorrhagic stroke. Hemorrhagic stroke has a higher risk of death than ischemic stroke. Hemorrhagic stroke can disrupt patient’s consciousness. The Glasgow Coma Scale (GCS) is a scale that is widely used to assess level of consciousness. Accurate predictors can help doctors determine prognosis and treatment for stroke patient. This study was conducted to determine the correlation of GCS scores at the time of hospital admission and mortality of hemorrhagic stroke patients at Hasan Sadikin Hospital. This study is a retrospective cohort analytic study involving 134 subjects. Data were analyzed using Kolmogorov-Smirnov’s and Fisher's analysis test with significance of p <0.05. From the results of the study, the p value was 0.00, subjects with GCS score somnolence (12-14) had six times higher risk in mortality (P = 0.02, RR = 6.38) and subjects with GCS score sopor and coma (3 - 11) had twenty four times higher risk in mortality (P = 0.00, RR = 23.85). We concluded that decreased score of SKG at the time of hospital admission was associated with increased risk of death in hemorrhagic stroke patients at Hasan Sadikin Hospital. Keywords: Glasgow Coma Scale, hemorrhagic stroke, mortality

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Assessment of Nurse’s Knowledge About Glasgow Coma Scale at al Dhafra Hospitals, Abu Dhabi, United Arab Emirates 2018

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc/03/07/00002 ◽

2018 ◽

Vol 3 (7) ◽

Keyword(s):

Glasgow Coma Scale ◽

United Arab Emirates ◽

Neurological Examination ◽

Abu Dhabi ◽

Patient Specific ◽

P Value ◽

Cross Sectional ◽

Coma Scale ◽

Level Of Consciousness ◽

The Difference

Background: The most important assessment in the neurological examination is to assess the level of consciousness (LOC), which is considered as the first step in neurological examination. Detecting the changes in level of consciousness depends on the accuracy of nursing assessment. The nurses should be knowledgeable, confident, and quick in performing this task. Purpose: of this study is to assess UAE nurses’ knowledge about GCS working in Al Dhafer Hospitals, Abu Dhabi, United Arab Emirates. Methodology: This study was carried out in the Dhafra hospitals, Abu Dhabi, United Arab Emirates in April 2018. It is a cross-sectional, descriptive study. Eighty-five nurses met the inclusion criteria, the survey was sent to 165 nurses (Respondent rate 51%). Data collection was carried out using a survey monkey instru¬ment called “Glasgow Coma Scale”. Data coding, entry and analysis has been conducted using SPSS 20 software. The difference has been tested at 95% level of significance, and the difference that has P-value < 0.05 was considered significant. Results: The study revealed that the knowledge percentages mean of correct answers about GCS is 56.1 % {SD: ±11.7; 95% CI: [26.67-100]}. On the other hand, it revealed also that the percentages of nurses who have a good knowledge about GCS were 50.6% and staffs whom have poor knowledge were 49.4 %. Moreover, the results revealed significant relation between gender and GCS training with level of GCS knowledge. Conclusion and recommendations: The present study showed that the nurses in Al-Dhafra hospitals reflect inadequate knowledge. This finding raises concerns about the importance of knowledge and skill in assessing GCS. Continuing education and practice on the use of the GCS tool are important. A Brochure and booklet should be designated and distributed to all nurses who working in critical care units and dealing with an unconscious patient. Specific and advanced courses about GCS should be conducted in Al-Dhafra hospitals.

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Relation of Volume of Hemorrhage With Mortality Within First 48 Hours in Hemorrhagic Stroke

KYAMC Journal ◽

10.3329/kyamcj.v12i3.56553 ◽

2021 ◽

Vol 12 (3) ◽

pp. 127-132

Author(s):

Sk Abdullah Al Mamun ◽

Saiyeedur Rahman ◽

Sayedur Rahman Sheikh ◽

Abdul Wadud ◽

Gobindo Gain

Keyword(s):

Mortality Rate ◽

Glasgow Coma Scale ◽

Intracerebral Hemorrhage ◽

Hemorrhagic Stroke ◽

Mortality Rates ◽

Advanced Age ◽

Coma Scale ◽

Level Of Consciousness ◽

Hemorrhage Volume ◽

Scale 8

Background: Hemorrhagic stroke accounts for 10-15% of all strokes with higher mortality rates than cerebral infarction. Intracerebral hemorrhage has a reported 30-day mortality of 44% to 51%, with almost half of the death occurs within the first 48 hours. Advanced age, low level of consciousness, large volume of hemorrhage has been linked with poor outcome. Objectives: To predict early outcome of hemorrhagic stroke patient in relation with age, Glasgow Coma Scale, volume of hemorrhage and ventricular extension. Materials and Methods: Hospital based prospective study carried out in hundred hemorrhagic stroke patients. The formula of ABC/2 was used to calculate hemorrhage volume in bedside by using CT scan. Results: 1st month mortality rates of hemorrhagic stroke was 44% with 45.45% of patients died within the first 48 hours of onset. Mean age of patients of hemorrhagic stroke was 61.2 ± 13.88 years. Mortality rate of intracerebral hemorrhage after age of 60 was 51.06% in 1st month. Volume of intracerebral hemorrhage was the strongest predictor of both 48 hours and 30 days mortality. Using three categories of intracerebral hemorrhage (X for < 30 ml, Y for 30 - 50 ml and Z for > 50 ml group) calculated by ABC/2 formula showed 100% mortality rate in Z group, 50% in Y group and only 12% mortality rate in X group in 1st month. Among all death, 61.5% of Z group 25% of Y group and 16.67% of patients of X group died within 48 hours. Two categories of Glasgow Coma Scale (≤ 8 and ≥ 9) were used and shown death rates 80.77% in GCS ≤ 8 and 4.55% in GCS ≥ 9 in 1st month. Conclusion: Volume of intracerebral hemorrhage in combination with advanced age, initial Glasgow Coma Scale is a powerful and easy to use in both 48 hours and 1st month mortality in patients with spontaneous intracerebral hemorrhage. KYAMC Journal. 2021;12(3): 127-132

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A comparison of the Full Outline of Unresponsiveness (FOUR) and Glasgow Coma Scale (GCS) Scores in Predicting Mortality Among Patients with Reduced Level of Consciousness in Uganda

Neurocritical Care ◽

10.1007/s12028-019-00806-4 ◽

2019 ◽

Vol 32 (3) ◽

pp. 734-741

Author(s):

Amir Abdallah ◽

Bart M. Demaerschalk ◽

Davis Kimweri ◽

Abdirahim Abdi Aden ◽

Nan Zhang ◽

...

Keyword(s):

Glasgow Coma Scale ◽

Coma Scale ◽

Level Of Consciousness

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Simple bedside assessment of level of consciousness: comparison of two simple assessment scales with the Glasgow Coma scale

Anaesthesia ◽

10.1111/j.1365-2044.2004.03526.x ◽

2004 ◽

Vol 59 (1) ◽

pp. 34-37 ◽

Cited By ~ 91

Author(s):

A. F. McNarry ◽

D. R. Goldhill

Keyword(s):

Glasgow Coma Scale ◽

Coma Scale ◽

Level Of Consciousness ◽

Assessment Scales ◽

Simple Bedside

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Evaluation of Level of Consciousness by the Glasgow Coma Scale in Children with Reye's Syndrome

Neurosurgery ◽

10.1227/00006123-198312000-00005 ◽

1983 ◽

Vol 13 (6) ◽

pp. 650-653 ◽

Cited By ~ 5

Author(s):

Charles C. Duncan ◽

Laura R. Ment ◽

Bennett A. Shaywitz

Keyword(s):

Central Nervous System ◽

Glasgow Coma Scale ◽

Central Nervous System Disease ◽

Rapid Progression ◽

Icp Monitoring ◽

Reye's Syndrome ◽

Coma Scale ◽

System Disease ◽

Level Of Consciousness ◽

Progression Of Disease

Abstract The Glasgow Coma Scale, which was designed to evaluate level of consciousness after head trauma, has been compared to the Lovejoy scale in 21 patients with Reye's syndrome. Like other investigators, we have noted a poorer prognosis in those patients with higher peak NH3 levels and rapid progression of disease. However, we have also noted that the Glasgow coma scale provides a better, earlier indicator of progressive central nervous system disease than the Lovejoy scale and, therefore, helps physicians caring for such patients to institute intracranial pressure (ICP) monitoring and vigorous measures for the control of elevated ICP earlier than they might otherwise.

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Assessment Of Jordanian Nurses' Knowledge To Perform Glasgow Coma Scale

European Scientific Journal ESJ ◽

10.19044/esj.2016.v12n27p208 ◽

2016 ◽

Vol 12 (27) ◽

pp. 208 ◽

Cited By ~ 1

Author(s):

Hamza Al-Quraan ◽

Mohannad Eid AbuRuz

Keyword(s):

Glasgow Coma Scale ◽

Assessment Tool ◽

Final Analysis ◽

Cross Sectional ◽

Coma Scale ◽

Inadequate Knowledge ◽

Level Of Consciousness ◽

Level Of Knowledge ◽

Jordanian Nurses ◽

Nurses Knowledge

The most important assessment of neurological examination in the clinical setting is assessing level of consciousness. The first neurological tool used to assess patients' level of consciousness was the Glasgow Coma Scale. It is considered as the most common less subjective gold standard coma assessment tool. The purpose of this study was to assess Jordanian nurses' knowledge about Glasgow Coma Scale. A non-experimental, descriptive cross-sectional correlational design was performed in four (3 private hospitals and 1 governmental) hospitals in Amman-Jordan. A self-reported questionnaire was answered by all (ICU, CCU, ER, and Telemetry) nurses who accepted to participate in the study. A total of 200 questionnaires were distributed to the participants with 90% response rate ending with 180 questionnaires in the final analysis. More than half of the sample (56.7%) was males. The participants were young nurses with mean age of 26.3±8 years. The total mean score for the whole sample was 7.38 ± 1.96. There was no relationship between experience, level of education, and training course and knowledge level. Nurses working in accredited hospitals and governmental hospitals recorded more level of knowledge than other hospitals. Emergency Room nurses recorded less level of knowledge than other area of practice. In conclusion, knowledge about Glasgow Coma Scale is a global problem. Jordanian nurses, as other nurses, have inadequate knowledge to perform Glasgow Coma Scale assessment. It is vital and necessary to include educational programs about Glasgow Coma Scale for nurses in all areas of practice and in the curricula of nursing colleges.

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