Interpretation of Pediatric Glasgow Coma Scale . Those with GCS scores available compose the study population for the current analysis. The 95% confidence limits were calculated using normal approximation methods. A total of 42,041 (95.8%) patients met the inclusion/exclusion criteria of the parent study, except that all patients with all GCS scores were eligible for the current study. Limitations of the Glasgow Coma Scale. The Pediatric Glasgow Coma Scale (PGCS) assesses the mental state of child patients. CT = computed tomography; GCS = Glasgow Coma Scale; ROC = receiver operating characteristic; TBI = traumatic brain injury.ROC curve for the test accuracy of GCS and clinically important TBI . As many of the assessments for an adult patient would not be appropriate for infants, the Glasgow Coma Scale was modified slightly to form the PGCS.
and you may need to create a new Wiley Online Library account.Enter your email address below and we will send you your usernameIf the address matches an existing account you will receive an email with instructions to retrieve your username Children under the age of 2 years may be given a different type of GCS.
The Pediatric Glasgow Coma Scale was developed as a modification of the adult GCS Scale to objectively measure neurologic function in head injuries. Although developed many years ago, the GCS remains an important scale. The GCS score is calculated by adding the scores of the following three components: eye response (range = 1–4), verbal response (range = 1–5), and motor response (range = 1–6).Due to the need for verbal interaction, clinicians cannot use the standard GCS score to appropriately assess preverbal children. This website also contains material copyrighted by 3rd parties. We compared the patient characteristics, rate of TBI on CT, and rate of ciTBI by GCS cohort using rate differences with 95% CI.We used receiver operating characteristic (ROC) curves with 95% CI to compare the total GCS score and its individual components against TBI on CT and ciTBI between the two GCS cohorts. Medicowesome Recommended for you. The results confirm that clinicians can use the pediatric GCS when evaluating those children presenting to the ED with blunt head trauma.
GCS = Glasgow Coma Scale; ROC = receiver operating characteristic; TBI = traumatic brain injury.ROC curve for the test accuracy of the individual GCS components (eye, verbal, motor) and TBI on CT . Only 36% of the study population underwent cranial CT imaging. This age threshold is somewhat conservative as some children older than 2 years may still be preverbal. Kuppermann, Holmes, and Borgialli interpreted the data; Drs. For those we could not reach by telephone or mail follow‐up, we reviewed the medical records, ED process improvement records, trauma registries, and county morgue records to ensure that no discharged patient was subsequently diagnosed with a ciTBI.Each variable was described for the pediatric and standard GCS cohorts using counts, percentages, and 95% confidence intervals (CIs) for categorical variables and the median and interquartile ranges (IQRs; 25th–75th percentile) for continuous variables. As per the parent study, TBI on CT was defined by the presence of intracranial blood, pneumocephalus, cerebral edema, diastasis of the skull, or skull fracture depressed by at least the width of the skull. Please confirm that you would like to log out of Medscape. To assess for interobserver agreement, we calculated the kappa statistics for the pediatric and standard GCS cohorts using the Fleiss‐Cohen weighted kappa with standard quadratic weights.
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