The prediction value of Glasgow coma scale-pupils score in neurocritical patients: a retrospective study. (16th April 2021)

• Record Type: Journal Article
• Authors: Lin, Yingxin; Zhang, Sheng; Zhang, Weixing; Wang, Xinxin; Huang, Lei; Luo, Hua
• Is Part Of: Brain injury. Volume 35:Number 5(2021)
• Page Start: 547
• Page End: 553
• Publication Date: 2021-04-16
• Subjects: Glasgow Coma Scale score -- Glasgow Coma Scale-pupils score -- intensive care unit -- prognosis -- pupil reactivity; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2021.1890821
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Background: External validation is necessary before its clinical recommendation in new setting. The aim is to externally validate Glasgow Coma Scale-pupils score (GCS-P) in neurocritical patients and to compare its performances with Glasgow Coma Scale (GCS) and its derivatives. Methods: GCS-P at admission was calculated for individual based on the model developed by Brennan et al. Area under the receiver operating characteristic curves (AUCs), Nagelkerke's R 2 and Brier scores were used to assess external validity of GCS-P to predict mortality in neurocritical patients and to compare predictive performance with GCS and its derivatives. Subjects: 4372 neurocritical patients from intensive care units of Beth Israel Deaconess Medical Center, United States between 2001 and 2012. Results: GCS-P showed good discrimination (AUC 0.847 for in-hospital mortality and 0.774 for ninety-day mortality), modest calibration (Nagelkerke's R2 33.1% for in-hospital mortality and 23.3% for ninety-day mortality). Predictive performances of GCS and its derivatives was inferior to GCS-P. Conclusions: GCP-P discriminated well in between death in neurocritical patients. GCP-P improved predictive performance for short-term mortality over GCS and its derivatives in neurocritical patients. It would be a simple, early and reasonable daily routine option for prognosis assessment in neurocritical setting.