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Revised Glasgow Coma Score Scale and Age for Predicting Long-Term Outcome Following Aneurysmal Subarachnoid Hemorrhage

Purpose: To identify a patient with aneurysmal subarachnoid hemorrhage who is likely to have a poor long-term outcome based on the study of Starke et al.

Description

Starke et al identified factors associated with long-term outcome following aneurysmal subarachnoid hemorrhage. These can help to identify patients who may not benefit from aggressive management. The authors are from Columbia University in New York City.


Patient selection: Hunt and Hess Grades 4 and 5 (stupor or coma = poor grade)

 

Unfavorable outcome: modified Rankin score of 4 to 6

 

Parameters:

(1) scale based on the admission Glasgow Coma Score (GCS)

(2) age of the patients in years

 

Glasgow Coma Score

Poor Grade GCS (PGS) Risk Group

Odds Ratio Unfavorable Outcome

13 to 15

not included

NA

10 to 12

A

1

8 or 9

B

14

5 to 7

C

38.5

3 or 4

D

63

 

An age >= 70 was associated with a poor outcome with an odds ratio of 7.5.

 

All patients >= 70 in risk groups C and D had an unfavorable long-term outcome.


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Specialty

Objective

ICD-10