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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2022
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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. |
format | Online Article Text |
id | pubmed-9303457 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
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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