Pediatric Glasgow Coma Scale Pdf For Printing
From the Department of Emergency Medicine, University of California Davis Health, Sacramento, CA.Disclosure: The authors declare no conflict of interest.Reprints: M. Austin Johnson, MD, PhD, 4150 V St, Suite 2100, Sacramento, CA 95817 (e-mail: ).M.A.J. Is the recipient of a training grant from the National Heart, Lung and Blood Institute (K12HL108964). This project was partly supported by the National Center for Advancing Translational Sciences, National Institutes of Health (Grant Numbers UL1 TR000002 and TL1 TR000133).Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site ( ). Objective An accurate understanding of the incidence of clinically important traumatic brain injuries (ciTBIs) based on presenting Glasgow Coma Scale (GCS) scores in pediatric patients is required to formulate a pretest probability of disease to guide testing and treatment. Our objective was to determine the prevalence of ciTBI and neurosurgical intervention for each GCS score (range 3–15) in children presenting after blunt head trauma.Methods This was a secondary analysis of prospectively collected observational data from 25 pediatric emergency departments in the Pediatric Emergency Care Applied Research Network.
Glasgow Coma Scale Interpretation
Patients younger than 18 years with nontrivial blunt head injury were included.Results A total of 43,379 children with complete GCS scores were included in the analysis. Seven hundred sixty-three children had ciTBIs (1.8%) and 200 underwent neurosurgery (0.5%).
Children with GCS scores of 4 had the highest incidence of ciTBI (21/22, 95.5%) and neurosurgical intervention (16/22, 72.2%). A nearly linear decrease in the prevalence of ciTBI from a GCS score of 4 to a score of 15 was observed ( R = 0.92). Of 1341 children, 107 (8.0%) presenting with GCS scores of 14 were found to have ciTBIs and 17 (1.3%) underwent neurosurgical intervention.Conclusions A nearly linear relationship exists between the initial GCS score and ciTBI in children with blunt head trauma. The highest prevalence of ciTBI and neurosurgical intervention occurred in children with GCS scores of 4. Children presenting with GCS scores of 14 had a nonnegligible prevalence of ciTBI. These findings are critical to providers caring for children with blunt head trauma to accurately formulate pretest probabilities of ciTBI.
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