Farrukh Iqbal, Ambreen Gul, Shahadat Hussain.
Predictive value of Glasgow Coma Scale (GCS) in cerebrovascular accidents.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;15(2):66-8.

There are various factors, which lead to coma and one of them is cerebrovascular accident (CVA). The severity of coma depends on the degree of brain damage. Various tools have been designed to measure the severity of coma including Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation (APACHE II), National Institute of Health (NIH) Stroke Scale, Modified Rankin Scale (MRS), Disability Rating Scale (DRS), Hunt Hess Scale (HHS) and Emergence Evaluation System (MESS). A study was carried out on 200 patients with stroke in the Department of Medicine, Shaikh Zayed Hospital, Lahore and predictive value of GCS was studied as regards outcome ill these patients with pattern of breathing, cerebral infarction, intracerebral bleed and mortality. One of the objectives was., to compare the results with other studies, which are very few in the literature. The patients were divided in three groups, I, II and III. The mortality was significantly higher in group I (p < 0.0001). Group l also had significantly higher rate of abnormal breathing (p < 0.0001). According to GCS scoring, the conscious level was worse in intracerebral bleed as compared to cerebral infarction (p < 0.0001), so was the high rate of mortality in intracerebral bleed as compared to cerebral infarction (p < 0.0001). Therefore it was concluded that GCS (3/15) is related inversely to mortality. It was also concluded that GCS of 7 was associated with high mortality than GCS of 12. In spite of few flaws in the GCS, it is still used in emergency medicine to evaluate degree of coma and will be used in future as an easy, quick and effective tool to measure the level of consciousness.

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