UMEM Educational Pearls

Title: Simplified GCS vs. Full GCS? Which One To Use?

Category: Neurology

Keywords: Glasgow Coma Scale, GCS, motor GCS, mGCS, Simplified Motor Scale, SMS (PubMed Search)

Posted: 4/12/2017 by WanTsu Wendy Chang, MD
Click here to contact WanTsu Wendy Chang, MD

 
Simplified GCS vs. Full GCS?  Which One To Use?

  • The Glasgow Coma Scale (GCS) is an instrument widely used to assess level of consciousness by EMS.
  • The motor GCS (mGCS) and Simplified Motor Scale (SMS) have been proposed to simplify EMS triage.
  • A number of retrospective studies have compared these scales.
  • Chou et al. performed a systematic review and meta-analysis of 18 studies with a total number of 1.7 million patients to compare the predictive utility of these scales for identification of patients with severe traumatic injury.
  • The total GCS was slightly better than the mGCS or SMS on predicting mortality, neurosurgical intervention, severe traumatic brain injury, and emergent intubation.

Bottom Line:  The motor GCS and Simplified Motor Scale (SMS) have similar discrimination when compared with the total GCS, and may be easier to use.

References

Chou R, Totten AM, Carney N, et al. Predictive Utility of the Total Glasgow Coma Scale Versus the Motor Component of the Glasgow Coma Scale for Identification of Patients with Serious Traumatic Injuries. Ann Emerg Med. 2017 Jan 11. [Epub ahead of print].

 

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