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Modified Glasgow Coma Scale Using Serum Factors as a Prognostic Model in Traumatic Brain Injury

Title
Modified Glasgow Coma Scale Using Serum Factors as a Prognostic Model in Traumatic Brain Injury
Author
김동원
Keywords
Decompressive craniectomy; Glasgow Coma Scale; Mortality; Outcome; Traumatic brain injury
Issue Date
2019-06
Publisher
ELSEVIER SCIENCE INC
Citation
WORLD NEUROSURGERY, v. 126, Page. 959-964
Abstract
BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and disability. This study evaluated a possible relationship between serum factors at admission and the outcome of TBI. We propose a statistically validated scale for patients with TBI that combines serum factors and the Glasgow Coma Scale (GCS). METHODS: Between May 2011 and July 2016, 219 patients underwent decompressive craniectomy for TBI. We assessed laboratory data on admission, and correlations with GSC and Glasgow Outcome Scale were investigated. The modified GCS was developed from a multivariable logistic regression model, which was validated with the backward stepwise method. RESULTS: Of 219 patients with TBI enrolled in our study, 175 were men (79.9%) and 44 were women (20.1%) with a mean age of 49.1 +/- 11.5 years. Initial serum values of hemoglobin, platelets, prothrombin time, and lactate dehydrogenase were associated with in-hospital mortality. The factor score was derived by adding the following points: hemoglobin (˃= 13.0 g/dL [0, ˂ 13.0 g/dL = 1), platelets (˃= 150 x 10(3)/mm(3) [0, ˂ 150 x 10(3)/mm(3) = 1), prothrombin time (˂ 13.2 seconds [0, ˃= 13.2 seconds = 1), and lactate dehydrogenase (˂ 271 U/L = 0, ˃= 271 U/L = 1). The modified GCS score (GCS score [range, 6-15] - FS [range, 0-4]) was calculated. CONCLUSIONS: The modified GCS score using serum factors extended the information provided about patient outcomes to be comparable to more complex methods. The modified GCS score may be useful to predict in-hospital mortality in patients with TBI.
URI
https://www.sciencedirect.com/science/article/pii/S1878875019306370?via%3Dihubhttps://repository.hanyang.ac.kr/handle/20.500.11754/151535
ISSN
1878-8750; 1878-8769
DOI
10.1016/j.wneu.2019.02.197
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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