Brennan et al modified the Glasgow Coma Score (GCS) by adjusting for the number of nonreactive pupils. This improves predictions at lower scores. The authors are from the University of Edinburgh and University of Glasgow.
Patient selection: traumatic brain injury
Parameters:
(1) Glasgow Coma Score, from 3 to 15
(2) number of nonreactive pupils, from 0 to 2
GCS-P =
= (Glasgow coma score) - (number of nonreactive pupils)
Interpretation:
• minimum score: 1
• maximum score: 15
• The lower the score the worse the prognosis.
GCS-P
Death
Unfavorable Outcome
1
74%
90%
2
65%
85%
3
41%
66%
4
39%
69%
5
33%
58%
6
25%
46%
7
19%
37%
8
20%
34%
9
19%
30%
10
17%
29%
11
12%
22%
12
9%
20%
13
7%
16%
14
6%
14%
15
2.5%
12%
where:
• Unfavorable outcome is death, vegetative state or severe disability.
• There is a plateau for mortality over scores 7 to 10.
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