Reliability of glasgow coma scale in traumatic brain injury: A retrospective analysis

Chawla, Hitesh; Tyagi, Ashish; Kumar, Ravinder

doi:10.5958/0974-0848.2020.00005.6

Cited by 2 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traumatic brain injury outcome was clinically assessed with the GOS at 12 months 5 ; those with a GOS score of 1 to 3 were classified as having an unfavorable outcome, and those with a GOS score of 4 to 5 were classified as having a favorable outcome. The 12-month outcome assessments were collected using a mixed-methods approach, including interviews performed either in person or via telephone.…”

Section: Methodsmentioning

confidence: 99%

“… 2 In clinical settings, sTBI is commonly classified using the Glasgow Coma Scale (GCS) at admission to the hospital, while the Glasgow Outcome Scale (GOS) is used to assess long-term clinical outcome. 5 Moreover, structural damage after sTBI may be detected by neuroimaging techniques. 6 Despite the proven effectiveness of these approaches, they have limitations in providing biochemical brain-related changes reflected in the bloodstream within a few hours after trauma.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Serum Brain-Derived Tau With Clinical Outcome and Longitudinal Change in Patients With Severe Traumatic Brain Injury

et al. 2023

View full text Add to dashboard Cite

ImportanceBlood-based measurements of total tau (T-tau) are commonly used to examine neuronal injury in patients with traumatic brain injury (TBI), but current assays do not differentiate between brain-derived tau (BD-tau) and tau produced in peripheral tissues. A novel assay for BD-tau has recently been reported that selectively quantifies nonphosphorylated tau of central nervous system origin in blood samples.ObjectivesTo examine the association of serum BD-tau with clinical outcomes in patients with severe TBI (sTBI) and its longitudinal changes over 1 year.Design, Setting, and ParticipantsThis prospective cohort study was conducted at the neurointensive unit at the Sahlgrenska University Hospital, Gothenburg, Sweden, between September 1, 2006, and July 1, 2015. The study included 39 patients with sTBI followed up for up to 1 year. Statistical analysis was performed between October and November 2021.ExposuresSerum BD-tau, T-tau, phosphorylated tau231 (p-tau231), and neurofilament light chain (NfL) measured on days 0, 7, and 365 after injury.Main Outcomes and MeasuresAssociations of serum biomarkers with clinical outcome and longitudinal change in sTBI. Severity of sTBI was evaluated using the Glasgow Coma Scale at hospital admission, while clinical outcome was assessed with the Glasgow Outcome Scale (GOS) at 1-year follow-up. Participants were classified as having a favorable outcome (GOS score, 4-5) or unfavorable outcome (GOS score, 1-3).ResultsAmong the 39 patients (median age at admission, 36 years [IQR, 22-54 years]; 26 men [66.7%]) in the study on day 0, the mean (SD) serum BD-tau level was higher among patients with unfavorable outcomes vs those with favorable outcomes (191.4 [190.8] pg/mL vs 75.6 [60.3] pg/mL; mean difference, 115.9 pg/mL [95% CI, 25.7-206.1 pg/mL]), while the other markers had smaller between-group mean differences (serum T-tau, 60.3 pg/mL [95% CI, −22.0 to 142.7 pg/mL]; serum p-tau231, 8.3 pg/mL [95% CI, −6.4 to 23.0 pg/mL]; serum NfL, −5.4 pg/mL [95% CI, −99.0 to 88.3 pg/mL]). Similar results were recorded on day 7. Longitudinally, baseline serum BD-tau concentrations showed slower decreases in the whole cohort (42.2% on day 7 [from 138.6 to 80.1 pg/mL] and 93.0% on day 365 [from 138.6 to 9.7 pg/mL]) compared with serum T-tau (81.5% on day 7 [from 57.3 to 10.6 pg/mL] and 99.0% on day 365 [from 57.3 to 0.6 pg/mL]) and p-tau231 (92.5% on day 7 [from 20.1 to 1.5 pg/mL] and 95.0% on day 365 [from 20.1 to 1.0 pg/mL]). These results did not change when considering clinical outcome, where T-tau decreased twice as fast as BD-tau in both groups. Similar results were obtained for p-tau231. Furthermore, the biomarker levels on day 365 were lower, compared with day 7, for BD-tau but not T-tau or p-tau231. Serum NfL had a different trajectory to the tau biomarkers, with levels increasing by 255.9% on day 7 compared with day 0 (from 86.8 to 308.9 pg/mL) but decreasing by 97.0% by day 365 vs day 7 (from 308.9 to 9.2 pg/mL).Conclusions and RelevanceThis study suggests that serum BD-tau, T-tau, and p-tau231 have differential associations with clinical outcome and 1-year longitudinal change in patients with sTBI. Serum BD-tau demonstrated utility as a biomarker to monitor outcomes in sTBI and can provide valuable information regarding acute neuronal damage.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Serum Brain-Derived Tau With Clinical Outcome and Longitudinal Change in Patients With Severe Traumatic Brain Injury

et al. 2023

View full text Add to dashboard Cite

show abstract

“…This scale scores the patient's ability in three areas of visual responses (score 1 -4), motor responses (score 1 -6), and verbal responses (score 1 -5). The overall score on the scale ranges from 3 to 15 (18).…”

Section: Glasgow Coma Scalementioning

confidence: 99%

Comparison of Pain Score in Patients with Brain Disorders Using Care Pain Observation Tool (CPOT) and Nonverbal Pain Scale (NVPS)

2022

View full text Add to dashboard Cite

Background: Traumatic brain injury (TBI) is one of the leading causes of death, which ranges from mild and irreversible to severe and life-threatening injuries. Objectives: This study aimed to compare the pain score in patients with brain disorders using Care Pain Observation Tool (CPOT) and Nonverbal Pain Scale (NVPS). Methods: A descriptive comparative study was performed in Ilam province, Iran, in a group of head trauma patients admitted to the intensive care unit who were intubated. One hundred twenty observations of nurses’ practice were performed. A purposive sampling method was utilized. The CPOT and NVPS assessed the pain, and the Glasgow Coma Scale (GCS) assessed the state of consciousness. Data were analyzed by SPSS version 16 software. Results: Patients’ mean ± SD age was 38.45 ± 4.2 years. The mean ± SD pain score on the CPOT before the procedure was 0.39 ± 0.49 in the facial expression dimension, 0.56 ± 0.49 in activity, 0.54 ± 0.50 in muscle tension, and 0.55 ± 0.49 in compatibility with the ventilator. The mean ± SD pain score on the NVPS before the procedure was 0.97 ± 0.20 in facial expression dimension, 0.94 ± 0.49 in activity, 0.95 ± 0.31 in guarding, 0.64 ± 0.49 in vital signs, and 0.92 ± 0.53 in excitement. Conclusions: Both CPOT and NVPS were effective in diagnosing patients’ pain, but the CPOT was more appropriate for diagnosing pain in intubated patients.

show abstract

Reliability of glasgow coma scale in traumatic brain injury: A retrospective analysis

Cited by 2 publications

References 0 publications

Association of Serum Brain-Derived Tau With Clinical Outcome and Longitudinal Change in Patients With Severe Traumatic Brain Injury

Association of Serum Brain-Derived Tau With Clinical Outcome and Longitudinal Change in Patients With Severe Traumatic Brain Injury

Comparison of Pain Score in Patients with Brain Disorders Using Care Pain Observation Tool (CPOT) and Nonverbal Pain Scale (NVPS)

Contact Info

Product

Resources

About