Never assess the condition of an elderly TBI based on a GCS score alone

Ref: Rau CS,et al.Int J Environ Res Public Health.
 2017 Nov 13;14 (11)pii: E1378doi: 10.3390/ijerph14111378The GCS (Glasgow Coma Scale) score and the AIS (Abbreviated Injury Scale) score are two of the most common methods for assessing the extent of injury in patients with cranial brain trauma (traumatibrain injury, TBI)Current evidence suggests that older patients with the same level of injury have higher GCS scores than younger patientsCompared with older patients with GCS 15-14 and 14-13, the mortality rate for older patients was 1.4 to 2.3 times higher than that of younger patientsThese studies did not take into account other factors that affect the prognosis, such as excessive blood loss, severe hyponatremia, hypoglycemia, and alcoholism, and no motor responses affected the patient's prognosisTo further study gcS scores to assess the effectiveness of the condition of elderly patients, Cheng-Shyuan Rau of Neurosurgery at Kaohsiung Changxuan Memorial Hospital in Taiwan, China, and others conducted the study, which was published in the November 2017 issue of Int J Environ Res Public Healthstudy included patients with traumatic brain injuries treated at the hospital between January 2009 and December 2016, divided into two groups by age, the older group (-65 years old) and the younger group (20-64 years)The degree of injury in TBI patients was assessed by AIS score, and the AIS score was divided into moderate injury and 5 was severeUsing tendentious scoring, the risk factors that may affect prognosis between the two groups of patients, such as chronic obstructive pulmonary disease (COPD), systolic blood, blood sugar, hemoglobin and blood alcohol content, were compared to the difference in GCS score and movement response between the two groups of patients by a 1:1 pairing methoda total of 2081 cases of moderate and severe TBI patients, of which 847 cases in the elderly and 1234 in young patientsIt is divided into 3 groups, depending on the AIS score: AIS 3, AIS 4, and AIS 5 After the tendentious score was matched, the GCS score of the elderly patients was higher than that of the younger patients in 162 patients in the AIS 3 group, with a score of 14.1 to 2.2 to 13.1 to 3.3 (p-0.002); Of the 362 patients in the AIS 4 group, the GCS score was also higher for the elderly patients, with a score of 13.1 to 3.3 to 12.2 to 3.8 (p-0.002), but the sports response score was not significantly higher than that of the younger patients, with a 5.4 to 1.2 to 5.2 to 1.3 (p.053) In the AIS 5 group, there was no significant difference in GCS and motion response scores between the two groups the study showed that in patients with moderate injury, the GCS scores in elderly patients were higher than in younger patients, suggesting that we should pay attention to the elderly patients with moderate injury in clinical work, and should not underestimate the injury of the elderly based solely on GCS scores (Second Hospital affiliated with Zhejiang University Medical College
TMC compiled, Fudan University affiliated Huashan Hospital Professor Wang Zhiqiu review, "Outside Information" editor-in-chief, Fudan University affiliated Huashan Hospital Chen Chengcheng Professor Final) related links