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Head Injury: (Balestreri et al, 2004; n = 358; mean age = 34 (16) years; Median GCS at admission = 6 (range from 3 to 13) points)

GCS score of 3 on presentation resulted in:

• 65% mortality rate (Fearnside et al, 1993)
• 100% mortality rate (Phuenpathom et al, 1993)

Head Injury: (Balestreri et al, 2004)

Brain Injury: (Balestreri et al, 2004; n = 358; mean age = 34 (16) years; Median GCS at admission = 6 (range from 3 to 15) points.

"The GCS's predictive validity, at least in predicting Glasgow Outcome Scores, is questionable. In some years the GCS demonstrated adequate correlations with the GOS (assessed 6 months later). In other years these correlations were poor."

Head Injury: presenting with a GCS of 3 six-months after injury: (Chamoun et al, 2009; n = 189; survivor mean age = 33.3 (12.8), patients who died 40.3 (16.97) years)

Head Injury: (Balestreri et al, 2004)

Head Injury (s/p blunt force trauma) (Shanmuganathan, et al., 2004; n= 21 patients with TBI secondary to blunt trauma mean age 37.8 (41.3) years; n=11 healthy control subjects, mean age 32.7 (19.2) years)

• Adequate correlation between whole brain apparent diffusion coefficient histogram values and GCS score (r squared = .67)

ICU Patients: (Fischer et al, 2010; n = 267; mean age = 63 (17) years; both assessments within 1 hour of each other) 

• Adequate: GCS inter-rater agreement = 71%
• Excellent: GCS  agreement +/- 1 point = 90%
• Inter-rater agreement was similar for neurologist and ICU staff

ICU (diagnosed with neurological diseases): (Ting et al., 2010; n= 154; mean age = 56.7 years; Total mortality ratio= 29.87%)

• GCS score < 5= 50% mortality rate, significantly higher rate than those with GCS >5 (p<0.01).
• GCS-Motor score ¡Ü 3 had a higher probability of mortality than patients with a GCS-M >3 (p< 0.01)
• GCS-Eye opening and GCS-Verbal scores of 1 had higher probability of mortality than patients with scores > 1 (p< 0.01)
• Patients had higher probability of mortality if GCS-E=1, CGS-V=1, and CGS-M=3 or less (p<.01).

Standard Cut Scores:

Emergency Department Patients: (Gill et al, 2004; n = 116; median age = 54 (18¨C90) years; diagnosis, trauma = 28% Infection = 16%)

• Exact agreement = 32%
• GCS Component Agreement:
  • Adequate: Eye = 74%
  • Poor: Verbal = 55%
  • Adequate: Motor = 72%

Emergency Department Patients: (Gill et al, 2004; n = 116; median age = 54 (18¨C90) years; diagnosis, trauma = 28% Infection = 16%; ratings by 2 residency trained attending emergency physicians, scores within 5 minutes)

• Exact agreement = 32% (Spearman rho=0.864)
• GCS Component Agreement:
  • Adequate : Eye = 74% (rho=.757)
  • Poor : Verbal = 55% (rho=.665)
  • Adequate : Motor = 72% (rho=.808)

55-74% of paired measurements were identical, and 6-17% were 2 or more points apart. Agreement was only moderate with this diverse ED population.

Pediatric TBI: (Chung et al, 2006;  n = 309; mean age = 6.19 (2.27) years; outcomes assessed at 4.11 (2.07) years on average; Taiwanese sample)

• Critical cut scores for the Glasgow Coma Scale score should be set slightly lower for children (5 points) than adults (8 points)
  • Low scores indicate the severity of brain injury and is considered predictive of death and potential of recovery.