Evaluating the Usefulness of Glasgow Coma Scale (GCS) in Diagnosing Traumatic Brain Injury: The Role in the Old Age Patients
DOI:
https://doi.org/10.37506/w2j7qr19Keywords:
head injury, brain, age of patients, fall, road traffic accidents.Abstract
Background: Several previous studies have questioned on the applicability of Glasgow Coma Scale (GCS) for patients with old age having Traumatic Brain Injury (TBI).
Aims and Objectives: To evaluate the usefulness of GCS in diagnosing TBI in relation to elderly people.
Materials and Method: A prospective study was performed involving 558 patients with brain injury out of that 126 had TBI. The GCS was assessed and compared with patients after dividing them into different age groups. Logistic regression was performed after adjusting for addition classical factors influencing the GCS like sex, Abbreviated Injury Scores (AIS) and mode of injury.
Results: We found a continuously increasing trend for GCS score with age of the patients having TBI. The similar trend was noted at all the level of severity. Logistic regression has shown a significant trend after adjusting for patients’ sex and mode of injury. However, level and height of the fall are the determining factors. GCS score increases significantly after the age of 44.
Conclusion: Greater weightage should be given to the age of the patients and the level and mode of injury to patients with TBI during the screening procedure.
References
Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013;9 (4):231–36.doi:10.1038/nrneurol.2013.22.
Bellner J, Jensen SM, Lexell J, Romner B. Diagnostic criteria and the use of ICD-10 codes to define and classify minor head injury. J Neurol Neurosurg Psychiatry. 2003;74(3):351–52.doi:10.1136/ jnnp.74.3.351.
Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;304(7872):81–84. doi:10.1016/S0140-6736(74)91639-0.
Batchelor J, McGuiness A. A meta-analysis of GCS 15 head injured patients with loss of consciousness or post-traumatic amnesia. Emerg Med J. 2002;19:515–19.doi:10.1136/emj.19.6.515.
Savitsky B, Givon A, Rozenfeld M, and Radomislensky I, and Peleg K. Traumatic brain injury: it is all about definition. Brain Inj. 2016; 30(6):1194–200.doi:10.1080/02699052.2016.1187290.
Salottolo K, Levy AS, Slone DS, Mains SW, Bar-Or D. The effect of age on Glasgow Coma scale score in patients with traumatic brain injury. JAMA Surg. 2014;149(7):727–34.doi:10.1001/ jamasurg.2014.13.
Kehoe A, Rennie S, Smith JE. Glasgow Coma Scale is unreliable for the prediction of severe head injury in elderly trauma patients. Emerg Med J. 2015;32:613–15.doi:10.1136/emermed2013-203488.
Rau C-S, Wu S-C, Chen Y-C, Chien P-C, Hsieh H-Y, Kuo P-J, Hsieh C-H. Effect of age on Glasgow Coma scale in patients with moderate and severe traumatic brain injury: an approach with propensity score-matched population. Int J Environ Res Public Health. 2017;14:1378.doi:10.3390/ijerph14111378.
Peleg K, Moskovich-Barkai J, Givon A, Goldman S A decade of trauma injuries in Israel 2000-2009: a national report. National Centre for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Centre, Tel Hashomer, 2011.
Granhed H, Altgarde E, Akyurek LM, David P. Injuries sustained by falls – a review. Trauma Acute Care. 2017;2(2):38–42.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
