Shumaila Mustaq, Tahira Bibi, Maria Sharif, Nazia Yousef.
Traumatic brain injury assessment using glasgow coma scale: a literature review.
Pak J Physiol Jan ;17(4):75-80.

Objective: The objective of this study was to analyse the Glasgow Coma Scale (GCS) reporting and recognize causes for inaccuracy of GCS implications. Literature selection and critical appraisal: Literature search was carried out by using specific keywords on PubMed, Google Scholar, and Science Direct. The GCS definitions, present status of GCS reporting, frequency and time of assessment, assessment schemes and confounders were critically analysed. Results: More than 90% of the publications using GCS scoring cite the 14-item GCS rather than the 15-item GCS. The timing of the initial GCS assessment is inconstant. GCS components are seldom utilized, contributing to the loss of information. Confounders are often not reported and, if they are, not in a standardized manner. The order of the GCS components is not consistent. Conclusion: The current inconsistent and inappropriate use of GCS diminishes its reliability in both clinical and scientific context. A consensus statement is needed to correct this situation. Citing the correct references, early and repeated GCS assessments at defined intervals, standardized reporting of confounders and GCS component and scores. Utilization of a uniform assessment scheme is recommended.

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