Validity of Glasgow Coma Scale - Pupil Age Charts in Predicting The Outcome for Patients with Traumatic Brain Injury

Abstract

Context: Glasgow Coma Scale (GCS) is considered a cornerstone of neurological assessment to distinguish the prognosis of traumatic brain injury patients.

Aim: This study aimed to examine the validity of the Glasgow coma scale - Pupil Age charts in predicting outcomes for patients with traumatic brain injury.

Methods: Descriptive exploratory research design was utilized to conduct this study at El-Fayoum University Hospitals and EL-Nabawi Mohandas General hospital in the Neurosurgical intensive care unit and neurosurgical inpatients ward. This research included a purposive sample of 100 adult patients with Traumatic Brain Injury using three tools for assessment. They were the patient's profile data form, the Glasgow Coma Scale - Pupil Age Charts, and the Glasgow outcome scale. Criterion validity with its two types of predictive validity and concurrent validity was used to validate GCS-Pupil Age charts.

Results: The study shows that the Glasgow Coma Scale-Pupil Age Chart is valid in predicting outcomes in patients with traumatic brain injury patient with the best cut-off value of <10.50, a sensitivity of 91.5%, and a specificity of 98.1%, while the Glasgow Coma Scale with the best cut off value <9.50, sensitivity 87.2%, and specificity of 94.3%. Glasgow Coma Scale-Pupil Age Charts and Computed tomography findings are valid in predicting outcomes following traumatic brain injury.

Conclusion: Glasgow Coma Scale-Pupil Age Charts and computed tomography finding chart are valid in predicting outcomes following traumatic brain injury. The current study recommended developing an educational program for nurses working in intensive care units about GCS and GCS- PA charts to assess traumatic brain injured patients. Besides, encouraging the use of GCS- PA charts in the emergency unit and neurosurgical intensive care unit to predict patient outcomes and plan the care for traumatic brain injury patients. Designing the clinical pathway for traumatic brain-injured patients from admission until discharge considering age, pupil reactivity response, and CT findings.