Reliability and predictive validity of outcome at discharge of Glascow coma scale in an intensive care unit population

authors:

avatar Somayeh momenyan1 , avatar faezeh kabiri , * , avatar Baharh gholamichaboki1 , avatar ali Arjmand3 , avatar reza Heidarifar4

Koomesh: Vol.19, issue 1; 129-134
article type: issue_documents_importer
received: January 02, 2016
accepted: September 01, 2016

how to cite: momenyan1 S, kabiri F, gholamichaboki1 B, Arjmand3 A, Heidarifar4 R. Reliability and predictive validity of outcome at discharge of Glascow coma scale in an intensive care unit population. koomesh. 2024;19(1):e151329. 

Abstract

Introduction: The Glasgow coma scale (GCS) score is a commonly used in the initial evaluation of patients with traumatic brain injury (TBI). The GCS has some limitations to evaluate the unconscious patients. This study aims to reliability and predictive validity of outcome at discharge of GCS in an intensive care unit population. Materials and Methods: This study is a cross-sectional method in 84 patients with acute brain injury in Shahid beheshti hospital in Qom (Iran). The inter-rater agreement for the GCS scores was evaluated by the weighted kappa. Outcome prediction power of the scales was assessed by the area under the curve (AUC) in the ROC curve. Results: In total, 168 ratings were performed for 84 patients by the GCS score. Inter-rater reliability for GCSC score was excellent. Cronbach’s showed a high degree of internal consistency for the GCS (α=0.82). The inter-rater agreement for each pair of raters was excellent (kw 0.838, 95% CI 0.889 - 0.987). The results show that scale is able to predict in-hospital mortality and poor outcome. The cut of point was 6. Conclusion: The researchers conclude that the reliability and predictive validity of Persian version of the GCS score is a valid scale. The present study shows that the Persian version of the GCS score is a reliable tool for the measurement of consciousness changes in TBI patients

References

  • 1.

    Hickey JV, Ryan M. (1997). Cerebral aneurysms. Hickey, J.V. The Clinical Practice of Neurological and Neurosurgical Nursing. (4th Ed.). Philadelphia: Lippincott: 569-584.

  • 2.

    Cohen J. Interrater reliability and predictive validity of the FOUR score coma scale in a pediatric population. J Neurosci Nurs 2009; 41: 261-267.

  • 3.

    Wijdicks EF. Clinical scales for comatose patients: the glasgow coma scale in historical context and the new FOUR Score. Rev Neurol Dis 2006; 3: 109-117.

  • 4.

    Teasdale G. Assessment of coma and impaired conscousness. Lancet 1974; 2: 81-84.

  • 5.

    Marshall LF, Gautille T, Klauber MR, Eisenberg HM, Jane JA, Luerssen TG, et al. The outcome of severe closed head injury. Special Supplements 1991; 75: S28-S36.

  • 6.

    Murthy T. A new score to validate coma in emergencydepartmentFOUR score. Indian J Neur 2009; 6: 59-61.

  • 7.

    Fischer M, Regg S, Czaplinski A, Strohmeier M, Lehmann A, Tschan F, et al. Research inter-rater reliability of the full outline of un responsiveness score and the glasgow coma scale in critically ill patients: a prospective observational study. 2010.

  • 8.

    Wolf CA, Wijdicks EF, Bamlet WR, McClelland RL, editors. Further validation of the FOUR score coma scale by intensive care nurses. Mayo Clinic Proceedings 2007; Elsevier.

  • 9.

    Bykcam F, Kaya U, Karakl M, avu UY, Turan SF, Odaba O. Predicting the outcome in children with head trauma: comparison of FOUR score and Glasgow Coma Scale. Ulus Travma Acil Cerrahi Derg 2012; 18: 469-473.

  • 10.

    Eken C, Kartal M, Bacanli A, Eray O. Comparison of the full outline of unresponsiveness score coma scale and the glasgow coma scale in an emergency setting population. Eur J Emerg Med 2009; 16: 29-36.

  • 11.

    Ebrahimi FH. The outcome of patients hospitalized with severe head injury in vali-asr hospital according to glascow coma scale in 2005-2006. 2010. (Persian).

  • 12.

    Molavi M, Kayalha H, Seddigh A. Comparison of acute physiology and chronic health evaluation score with glasgow coma scale for predicting hospital mortality in neurosurgical patients. J Qazvin Univ Med Sci 2013; 17: 58-62. (Persian).

  • 13.

    Soltanian M, Farokhi A, Ghorbani R, Moghaddam A, Zarezade M. Evaluation of the reliability and construct validity of test of gross motor development-2 (Ulrich 2) in children of Semnan province. Koomesh 2013; 14: 200-206. (Persian).

  • 14.

    Heidari M, Akbarfahimi M, Salehi M, Nabavi S. Validity and reliability of the Persian-version of fatigue impact scale in multiple sclerosis patients in Iran. Koomesh 2014; 15: 295-301. (Persian).

  • 15.

    Akavipat P. Endorsement of the FOUR score for consciousness assessment in neurosurgical patients. Neurol Med Chir (Tokyo) 2009; 49: 565-571.

  • 16.

    Rowley G, Fielding K. Reliability and accuracy of the glasgow coma scale with experienced and inexperienced users. The Lancet 1991; 337: 535-538.

  • 17.

    Balestreri M, Czosnyka M, Chatfield D, Steiner L, Schmidt E, Smielewski P, et al. Predictive value of Glasgow Coma scale after brain trauma: changein trend over the past ten years. J Neurol Neurosurg Psychiatry 2004; 75: 161-162.

  • 18.

    mohammadi R sH, Nikravan mofrad, Zayeri F. Correlation between the glasgow coma scale and full outline of unresponsiveness with physiological indicators to determine altered level of consciousness in adult patient with brain damages to intensive care unit, 2013. Clin Res Paramed Sci 2014; 3: 237-246. (Persian).##.