Glasgow Coma Scale Motor Component (“Patient Does Not Follow Commands”) Performs Similarly to Total Glasgow Coma Scale in Predicting Severe Injury in Trauma Patients

Kupas, Douglas F.; Melnychuk, Eric; Young, Amanda

doi:10.1016/j.annemergmed.2016.06.017

Cited by 40 publications

(35 citation statements)

References 17 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The use of motor score alone has been shown to be as accurate as the summed GCS in traumatic brain injury. 4 In our present model, we propose the 'Maritzburg score'; by using only two simple clinical variables: the presence of visible brain matter and a motor score less than 5 allows accurate identification of nonsurvivors.…”

Section: Discussionmentioning

confidence: 99%

“…Recent literature suggested that the motor component of GCS performs as well as the summed GCS in predicting mortality of patients with traumatic brain injury. 4 Furthermore, eye opening and verbal response may be difficult to assess accurately in the resuscitation room, where patients are often intoxicated and may have other confounding factors, such as facial swelling. In light of this, we designed our current study to propose a more simplified clinical score that would allow early prediction of mortality in patients with isolated cerebral gunshot wounds.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Developing a simplified clinical prediction score for mortality in patients with cerebral gunshot wounds: The Maritzburg Score

Kong

Odendaal

Sartorius

et al. 2018

annals

View full text Add to dashboard Cite

Introduction Cerebral gunshot wounds are highly lethal and literature on the clinical scores for mortality prediction is limited. Materials and methods A retrospective study was undertaken over a 5-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa. A simplified clinical prediction score was developed based on clinical and/or physiological variables readily available in the resuscitation room. Results A total of 102 patients were included; 92% (94/102) were male and the mean age was 29 years; 22% (22/102) died during the admission. The presence of visible brain matter (odds ratio 12.4, P = 0.003) and motor score less than 5 (odds ratio 89.6, P < 0.001) allows the prediction success of 92% (sensitivity 73% and specificity 98%). The area under the receiver operating characteristic curve was 94% (95% confidence interval 88-100%, P < 0.001). Conclusions The presence of visible brain matter, together with a motor score of less than 5, allows accurate identification of non-survivors of cerebral gunshot wounds. Further study is required to validate this score.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developing a simplified clinical prediction score for mortality in patients with cerebral gunshot wounds: The Maritzburg Score

Kong

Odendaal

Sartorius

et al. 2018

annals

View full text Add to dashboard Cite

show abstract

“…This is in line with the conclusions of Rubenson Wahlin (2016); in their study, patients' level of consciousness was assessed in less than 40% of the cases. The importance of the assessment is to avoid undertriaging a patient with potentially serious injuries or overtriaging, which would strain trauma resources (Kupas, Melnychuk, & Young, 2016). The proportion of participants applying a cervical collar increased in both groups, from the first to the last simulation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Repeated Simulation on the Quality of Trauma Care

Abelsson

Lindwall

Suserud

et al. 2017

Clinical Simulation in Nursing

View full text Add to dashboard Cite

Background: Simulation participants are not dependent on learning during an actual clinical situation. This allows for a learning environment that can be constructed to meet the knowledge and experience needs of the participant. Simulations in a prehospital emergency are an ideal way to address these needs without risking patient safety. Method: Nurses in prehospital emergency care (n ¼ 63) participated in simulation interventions. During the simulation, the performed trauma care was assessed in two groups of participants with different frequency of simulation. Results: Several statistically significant differences and clinical improvements were found within and between the groups. Differences were noted in specific assessments, examinations, care actions, and time from assessment to action. Conclusion: The result suggested that repeated simulation may contribute to a clinical improvement in trauma care, and more frequent simulation may led to even greater improvements.

show abstract

“…Уровень сознания регистрировали по 3-м шкалам: Глазго, Four, Giocino [3][4][5][6][7][8]. За достоверную положительную клиническую динамику принимали переход пациента по шкале Giocino (2002) на один и более уровень в градации сознания (вегетативное состояние; состояние минимального сознания; минимальное сознание «+»; норма сознания).…”

Section: Methodsunclassified

“…The level of consciousness was assessed using 3 scales: Glasgow, Four, Giocino [3][4][5][6][7][8]. Changes in patient's level of consciousness by one or more level according to the Giocino scale (2002) (vegetative state; a state of minimal consciousness; minimal consciousness «+»; normal consciousness) were taken as significant positive dynamics.…”

Section: результаты и обсуждениеmentioning

confidence: 99%

Monitoring of the Effectiveness of Intensive Care and Rehabilitation by Evaluating the Functional Activity of the Autonomic Nervous System in Patients with Brain Damage

Кирячков¹,

Grechko²,

Kolesov³

et al. 2018

rmt

View full text Add to dashboard Cite

Purpose: evaluation of the clinical significance of parametric monitoring of the effectiveness of intensive care and rehabilitation based on the analysis of the functional state of the autonomous nervous system in patients with brain damage of different genesis.Materials and methods. The study included 66 patients on day 20—50 after the traumatic brain injury; anoxic damage; and stroke consequences. The isolation of clinical groups and subsequent analysis of clinical status is based on the analysis of the functional state of the autonomic nervous system based on the dynamics of the heart rate variability (HRV) parameters. Findings obtained in studies of 500 patients in the postoperative period with a 5-minute HRV were tested as normal and abnormal ANS parameters [1]. Parasympathetic hyperactivity was measured within the limits for SDNN (standard deviation of all normal-to-normal R-R intervals) > 41.5 ms; for rMSSD (root-meansquare of the successive normal sinus R-R interval difference) > 42.4 ms; for pNN50% (the percentage of interval differences in successive NN intervals greater than 50 ms (NN50) / total number of NN intervals) > 8.1%; for SI (Baevsky stress index, in normalized units) < 80 n. u.; for TP (total power of variance of all NN intervals) > 2000 ms2. Sympathetic hyperactivity was determined within the limits for following parameters: SDNN, < 4.54 ms; rMSSD, < 2.25 ms; pNN50%, < 0.109%; SI, > 900 n. u.; TP < 200 ms2. Normal HRV parameters were selected within the limits of the values for: SDNN [13.31-41.4ms]; rMSSD [5.78—42.3 ms]; pNN50% [0.110—8.1%]; SI [80—900 nu]; for TP [200—2000 ms2]. To verify the parasympathetic or sympathetic hyperactivity within these limits, 3 of 5 parameters were chosen [1].Results. Based on the dynamics of the HRV parameters before the intensive care and on days 30—60 of the intensive therapy and rehabilitation of patients with traumatic and non-traumatic brain injuries, 5 main clinical groups of patients were identified. Group 1 (n=27) consisted of patients with normal parameters of the ANS functional activity (both at the time of admission to the hospital and on the 30—60th day of the intensive therapy and rehabilitation). Group 2 (n=9) included patients with the baseline sympathetic hyperactivity of the ANS at admission to the intensive care unit and normal functional activity of the ANS on the 30—60th day of the intensive care and rehabilitation. Group 3 (n=8) included patients with baseline normal functional state of the ANS and the signs of sympathetic hyperactivity of the ANS on the 30—60th day of the intensive care and rehabilitation. Group 4 (n=15) consisted of patients with signs of sympathetic hyperactivity of the ANS both initially and on the 30—60th day of the intensive care and rehabilitation. Group 5 (n=7) included patients with signs of parasympathetic hyperactivity of the ANS (according to the parameters of HRV) both at baseline, at admission to the intensive care unit, and on the 30—60th day of the intensive care and rehabilitation.Conclusion: The normalization of HRV parameters is accompanied by patients’ recovery from the vegetative state and coma to minimal consciousness or normal consciousness; the index of disability rate decreases, the social reintegration grows, according to the DRS scale (M. Rappaport, 1982); dependence on mechanical ventilation reduces, and the muscle tone normalizes.

show abstract

Glasgow Coma Scale Motor Component (“Patient Does Not Follow Commands”) Performs Similarly to Total Glasgow Coma Scale in Predicting Severe Injury in Trauma Patients

Cited by 40 publications

References 17 publications

Developing a simplified clinical prediction score for mortality in patients with cerebral gunshot wounds: The Maritzburg Score

Developing a simplified clinical prediction score for mortality in patients with cerebral gunshot wounds: The Maritzburg Score

Effect of Repeated Simulation on the Quality of Trauma Care

Monitoring of the Effectiveness of Intensive Care and Rehabilitation by Evaluating the Functional Activity of the Autonomic Nervous System in Patients with Brain Damage

Contact Info

Product

Resources

About