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An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury

The wide‐spread use of an initial ‘Glasgow Coma Scale (GCS) 8 or less’ to define and dichotomise ‘severe’ from ‘mild’ or ‘moderate’ traumatic brain injury (TBI) is an out‐dated research heuristic that has become an epidemiological convenience transfixing clinical care. Triaging based on GCS can dela...

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Autores principales: Fitzgerald, Mark, Tan, Terence, Rosenfeld, Jeffrey V, Noonan, Michael, Tee, Jin, Ng, Evan, Mathew, Joseph, Broderick, Shane, Kim, Yesul, Groombridge, Christopher, Udy, Andrew, Mitra, Biswadev
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303457/
https://www.ncbi.nlm.nih.gov/pubmed/35220682
http://dx.doi.org/10.1111/1742-6723.13937
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author Fitzgerald, Mark
Tan, Terence
Rosenfeld, Jeffrey V
Noonan, Michael
Tee, Jin
Ng, Evan
Mathew, Joseph
Broderick, Shane
Kim, Yesul
Groombridge, Christopher
Udy, Andrew
Mitra, Biswadev
author_facet Fitzgerald, Mark
Tan, Terence
Rosenfeld, Jeffrey V
Noonan, Michael
Tee, Jin
Ng, Evan
Mathew, Joseph
Broderick, Shane
Kim, Yesul
Groombridge, Christopher
Udy, Andrew
Mitra, Biswadev
author_sort Fitzgerald, Mark
collection PubMed
description The wide‐spread use of an initial ‘Glasgow Coma Scale (GCS) 8 or less’ to define and dichotomise ‘severe’ from ‘mild’ or ‘moderate’ traumatic brain injury (TBI) is an out‐dated research heuristic that has become an epidemiological convenience transfixing clinical care. Triaging based on GCS can delay the care of patients who have rapidly evolving injuries. Sole reliance on the initial GCS can therefore provide a false sense of security to caregivers and fail to provide timely care for patients presenting with GCS greater than 8. Nearly 50 years after the development of the GCS – and the resultant misplaced clinical and statistical definitions – TBI remains a heterogeneous entity, in which ‘best practice’ and ‘prognoses’ are poorly stratified by GCS alone. There is an urgent need for a paradigm shift towards more effective initial assessment of TBI.
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spelling pubmed-93034572022-07-28 An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury Fitzgerald, Mark Tan, Terence Rosenfeld, Jeffrey V Noonan, Michael Tee, Jin Ng, Evan Mathew, Joseph Broderick, Shane Kim, Yesul Groombridge, Christopher Udy, Andrew Mitra, Biswadev Emerg Med Australas Perspectives The wide‐spread use of an initial ‘Glasgow Coma Scale (GCS) 8 or less’ to define and dichotomise ‘severe’ from ‘mild’ or ‘moderate’ traumatic brain injury (TBI) is an out‐dated research heuristic that has become an epidemiological convenience transfixing clinical care. Triaging based on GCS can delay the care of patients who have rapidly evolving injuries. Sole reliance on the initial GCS can therefore provide a false sense of security to caregivers and fail to provide timely care for patients presenting with GCS greater than 8. Nearly 50 years after the development of the GCS – and the resultant misplaced clinical and statistical definitions – TBI remains a heterogeneous entity, in which ‘best practice’ and ‘prognoses’ are poorly stratified by GCS alone. There is an urgent need for a paradigm shift towards more effective initial assessment of TBI. Wiley Publishing Asia Pty Ltd 2022-02-27 2022-06 /pmc/articles/PMC9303457/ /pubmed/35220682 http://dx.doi.org/10.1111/1742-6723.13937 Text en © 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Perspectives
Fitzgerald, Mark
Tan, Terence
Rosenfeld, Jeffrey V
Noonan, Michael
Tee, Jin
Ng, Evan
Mathew, Joseph
Broderick, Shane
Kim, Yesul
Groombridge, Christopher
Udy, Andrew
Mitra, Biswadev
An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury
title An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury
title_full An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury
title_fullStr An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury
title_full_unstemmed An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury
title_short An initial Glasgow Coma Scale score of 8 or less does not define severe brain injury
title_sort initial glasgow coma scale score of 8 or less does not define severe brain injury
topic Perspectives
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303457/
https://www.ncbi.nlm.nih.gov/pubmed/35220682
http://dx.doi.org/10.1111/1742-6723.13937
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