Evaluating the Usefulness of Glasgow Coma Scale (GCS) in Diagnosing Traumatic Brain Injury: The Role in the Old Age Patients

Jitendra Tanna,  Vanraj N. Parmar, Sunil B. Bhatt
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Abstract

Background: Several previous studies have questioned on the applicability of Glasgow Coma Scale (GCS) for patients with old age having Traumatic Brain Injury (TBI). Aims and Objectives: To evaluate the usefulness of GCS in diagnosing TBI in relation to elderly people. Materials and Method: A prospective study was performed involving 558 patients with brain injury out of that 126 had TBI. The GCS was assessed and compared with patients after dividing them into different age groups. Logistic regression was performed after adjusting for addition classical factors influencing the GCS like sex, Abbreviated Injury Scores (AIS) and mode of injury. Results: We found a continuously increasing trend for GCS score with age of the patients having TBI. The similar trend was noted at all the level of severity. Logistic regression has shown a significant trend after adjusting for patients’ sex and mode of injury. However, level and height of the fall are the determining factors. GCS score increases significantly after the age of 44. Conclusion: Greater weightage should be given to the age of the patients and the level and mode of injury to patients with TBI during the screening procedure.
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评估格拉斯哥昏迷量表(GCS)在诊断创伤性脑损伤中的实用性:在老年患者中的作用
背景:之前的一些研究对格拉斯哥昏迷量表(GCS)是否适用于老年创伤性脑损伤(TBI)患者提出了质疑。目的和目标:评估格拉斯哥昏迷量表在诊断老年人创伤性脑损伤方面的实用性。材料与方法:对 558 名脑损伤患者进行了前瞻性研究,其中 126 人患有 TBI。在将患者分为不同年龄组后,对他们的 GCS 进行了评估和比较。在调整了性别、简略损伤评分(AIS)和损伤方式等影响 GCS 的其他传统因素后,进行了逻辑回归。结果:我们发现随着年龄的增长,创伤性脑损伤患者的 GCS 评分呈持续上升趋势。所有严重程度的创伤均呈类似趋势。在对患者的性别和受伤方式进行调整后,逻辑回归显示出明显的趋势。然而,跌倒的程度和高度是决定因素。GCS 评分在 44 岁以后明显增加。结论在筛查过程中,应更加重视创伤性脑损伤患者的年龄、受伤程度和方式。
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