Outcome from tbi is frequently described using the glasgow outcome scale at 6 months following tbi table 6. The combi is an online resource center catologuing information on brain injury outcome and assessment scales. The glasgow outcome scale 40 years of application and. The glasgow outcome scale gos was commonly used before other scales were developed. The original scale was a 14point scale, omitting the category of abnormal flexion. Nov 24, 2014 the glasgow outcome scale gos categorizes the outcomes of patients after traumatic brain injury, as follows. Pdf the glasgow outcome scale gos is the most widely used outcome measure after traumatic brain injury, but it is increasingly. Teasdale2 1department of psychology, university of stirling, stirling, uk 2department of neurosurgery, university of glasgow, glasgow, uk abstract. Glasgow coma scale eye opening response spontaneousopen with blinking at baseline 4 points to verbal stimuli, command, speech 3 points to pain only not applied to face 2 points no response 1 point verbal response oriented 5 points confused conversation, but able to answer questions 4 points inappropriate words 3.
Loevner md, in radiology secrets plus third edition, 2011. Glasgow outcome scale how is glasgow outcome scale. Pdf structured interviews for the glasgow outcome scale and the. The authors examined the utility of the gos during early treatment as a predictor of outcome score 15 months postinjury by analyzing outcome score change in a group of patients with closed head injuries. The combi contains information on over 25 outcome or assessment scales. Fiftysix headinjured patients were interviewed by telephone and then facetoface interviews were carried out by a different person up to 1 month later. Mean interval between completion of first questionnaire and second questionnaire 14. The glasgow outcome score applies to patients with brain damage allowing the objective assessment of their. With over 4,000 citations to the original paper, it is the most highly cited outcome measure in. Emotional and cognitive consequences of head injury in relation to the glasgow outcome scale. Validity of a pediatric version of the glasgow outcome. Structured interviews for the glasgow outcome scale and the extended glasgow outcome scale.
The glasgow outcome scale assesses patients with traumatic brain injury in terms of neurological status and degree of disability. Teasdale2 abstract the glasgow outcome scale gos is the most widely used outcome measure after traumatic brain injury, but it is increasingly recognized to have. While the 15point scale is the predominant one in use, this is in fact a modification and is more correctly referred to as the modified glasgow coma scale. Do it this way rate for factors interfering with communication, ability to respond and other injuries eye opening, content of speech and movements of right and left sides sound. Page 1 the glasgow coma scales the glasgow coma scale gcs is the most widely used scoring system used in quantifying the level of consciousness following traumatic brain injury. However, the gos has been criticized for its lack of sensitivity to detect small but clinically relevant changes in outcome. This study was set up to test the reliability of the glasgow outcome scale gos when information was obtained from different sources. It is proposed that shortcomings of the gos can be addressed by adopting a standard format for the interview used to assign outcome. The scale consists of five ordinal outcome categories.
The glasgow coma scale was devised to provide a uniform approach to clinical assessment of trauma patients with acute head trauma. The gos is helpful in determining next steps in the individuals care, but is not useful in detecting small, gradual improvements. It is a simple, hierarchical rating scale with a limited number of broad categories. Glasgow coma scale gcs and glasgow outcome score extended gose currently, one of the bases for a client to be deemed cat is the glasgow coma score gcs. Glasgow outcome scale how is glasgow outcome scale abbreviated. It uses unambiguous terms that are readily understood by a wide. Lu j, marmarou a, lapane k, turf e, wilson l, impact group, et al.
The extended glasgow outcome scale gose addresses the limitations of the first version and comes with an 8 item rating system and a structured interview available to use with. Does the extended glasgow outcome scale add value to the. Spearman correlations were comparable and strongest among discharge gcs and four scores and 12month outcome r. The gcs measures a clients ability to open their eyes, respond to verbal stimuli and obey motor commands, and is administered by emergency and medical. A comparative study of glasgow coma scale and full outline o. Glasgow outcome scale gos the glasgow outcome scale gos is a brief, oneitem descriptive assessment utilized by the treatment team following brain injury. Mass trauma resources glasgow coma scale pdf version requires acrobat reader if this page does not refresh click here. The first description was in 1975 by jennett and bond. Extended glasgow outcome scale gose faces pain scale revised fpsr fatigue severity scale fss fibromyalgia impact questionnaire fiqr. Outcome in patients with blunt head trauma and a glasgow coma scale score of 3 at presentation. The glasgow outcome scale gos categorizes the outcomes of patients after traumatic brain injury, as follows. Predictive ability of glasgow coma scale scores in head. It is a very general assessment of the general functioning of the person who suffered a head injury. Perhaps the most widely used pediatric outcome measure in the hospital is the pediatric cerebral performance scale pcpc, an instrument modeled after the glasgow outcome scale gos and constructed to measure shortterm cognitive disability after lifethreatening medical events fiser, 1992.
Structured interviews for the glasgow outcome scale and the. The gcs measures a clients ability to open their eyes, respond to verbal stimuli and obey motor commands, and. Glasgow outcome scale extended rehabmeasures database. Glasgow coma scale on presentation predicts outcome in. Patient who is dependent for daily support for mental or physical disability, usually a combination of both. Eighty assessments were carried out on a group of 58 patients at three different time intervals up to 24 months postinjury. Consequently the pediatric glasgow coma scale, a separate yet closely related scale, was developed for assessing younger children. The glasgow outcome scale gos is the most widely used outcome measure after traumatic brain injury, but it is increasingly recognized to have important limitations. Glasgow outcome scale scores were assigned at 6 and 12 months. The glasgow outcome scale gos is a global scale for functional outcome that rates patient. Jan 21, 20 predictive value of glasgow coma scale after brain trauma.
By comparison, the second version has shown more reliability in practice and content validity and is also more sensitive to change in mild and moderate traumatic brain. The glasgow outcome scale gos is widely used to assess outcome after head injury, but is recognized as having a number of shortcomings that are highlighted and investigated in. Analyzing outcome of treatment of severe head injury. May 2004 page 1 of 1 neurological assessment using the glasgow coma scale gcs expected outcome the glasgow coma score forms part of the patients physical assessment and will be assessed and documented during physical assessment. Glasgow coma scale brain injury association of america. Does an early glasgow outcome scale gos assessment provide a reliable indicator of later outcome in a patient with traumatic brain injury tbi.
Predictive value of an early glasgow outcome scale score. Glasgow outcome scale synonyms, glasgow outcome scale pronunciation, glasgow outcome scale translation, english dictionary definition of glasgow outcome scale. The extended glasgow outcome scale gose is a hierarchical scale in which the patients overall rating score is based on the lowest outcome category indicated by the response to the questionnaire. Structured interviews for the glasgow outcome scale and. Glasgow outcome scale article about glasgow outcome scale. It has been criticized as lacking sensitivity to functionally significant changes. The glasgow outcome scale gos is perhaps the most widely used measure for assessing global outcome following a brain injury. Glasgow coma scale gcs is a neurological scale aiming to provide a reliable, objective way of recording the conscious state of a person, both for initial and continuing assessment of the patient, which has a special value in predicting the ultimate outcome. The glasgow outcome scale gos is a scale so that patients with brain injuries, such as cerebral traumas can be divided into groups that allow standardised descriptions of the objective degree of recovery. In contrast to the above studies using the gosbased categories as outcome measures, a few researchers chose to include outcome measures that more specifically reflected the. Mental handicap contributed more significantly to overall social disability than did neurological deficits. The glasgow outcome scale gos was first published in 1975 by bryan jennett and michael bond.
Presenting with a glasgow coma scale score of meant that the odds of reaching the primary end point of functional independence defined as a 90day modified rankin scale score of 02 were 5. Materials available include scale syllabi, administration and scoring guidelines, training and testing materials, data on scale properties, references, scale forums. A method for reducing misclassification in the extended glasgow outcome score. The scale presented here is based on the original article by jennett and bond. The glasgow outcome score gos is a scale of patients with brain injuries, such as cerebral traumas that groups victims by the objective degree of recovery. It is used because it is simple, has a relatively high degree of reliability and correlates well with outcomes following severe brain injury.
Glasgow outcome scale an overview sciencedirect topics. This is a widely accepted and standardized scale that is of value for the clinical description of patients and also for medicolegal documentation and research purposes. Jun 02, 2014 extended glasgow outcome scale gose faces pain scale revised fpsr fatigue severity scale fss fibromyalgia impact questionnaire fiqr. Reliability of ratings on the glasgow outcome scales from in. The glasgow outcome scale is a 5point score given to victims of traumatic brain injury at some point in their recovery. Predictive value of glasgow coma scale after brain trauma. Jan 01, 2012 the glasgow outcome scale gos is firmly established as the primary outcome measure for use in phase iii trials of interventions in traumatic brain injury tbi. The glasgow coma scale gcs was devised to assess injury severity in a multicentre study of outcome after severe brain damage. For example, when a patient has answered that they are unable to work to question 5b, which would indicate lower moderate. Agreement between ratings on the gos and the extended gos gose in each of the studies was assessed using the. The glasgow coma score gcs is a commonly used index for evaluating the level of consciousness and overall status of the central nervous system. G l a s g o w o u t c o m e s c a l e level description 1 death.
All subjects were evaluated at hospital discharge time with glasgow outcome scale. G l a s g o w o u t c o m e s c a l e scalelibrary. If the patient can be left alone for more than 8h at home. Relative friend carer alone extended date of interview. Glasgow coma scale centers for disease control and. As a brief descriptive outcome scale it has been replaced by the drs, although it is still seen occasionally in the literature, especially in studies investigating early acute medical predictors of gross outcome. This social handicap is readily described by the glasgow outcome scale, an extended version of which is described and compared with alternatives. Teasdale gm, pettigrew le, wilson jt, murray g, jennett b. Spontaneousopen with blinking at baseline 4 points. Description the glasgow outcome scale is a practical index of social outcome following head injury designed to complement the glasgow coma scale as the basis of a predictive system jennett and bond, 1975, jennett et al. Glasgow outcome scale definition of glasgow outcome scale. The glasgow outcome scale gos is a global scale for functional outcome that rates patient status into one of. Glasgow coma scale an overview sciencedirect topics.
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