Severe head injury is associated with considerable morbidity and mortality. The Glasgow Outcome Scale is one of several ways of measuring the outcome after head injury. Extended (8 categories) and contracted (2 or 3) variations exist.
Original Scale (Score)
Abbreviation
Description
death (1)
D
dead
persistent vegetative state (2)
PVS
wakefulness without awareness; absence of speech or evidence of mental function in a patient who appears awake with spontaneous eye opening
severe disability (3)
SD
conscious but dependent; patient requires assistance to perform daily activities and cannot live independently
moderate disability (4)
MD
independent but disabled; patient unable to return to work but otherwise able to independently perform the activities of daily living
good recovery (mild or no disability, 5)
GR
reintegrated but may have nondisabling sequelae; able to return to work but not necessarily at the same level; may have minor neurological or psychological impairments
Based on the pattern of clinical signs at 24 hours after injury, it is possible to give a likelihood for the major outcome groups. Patients may divided into 5 groups as follows:
Clinical Signs at 24 Hours
Grp 1
Grp 2
Grp 3
Grp 4
Grp 5
Any 2 of the following reacting (pupils, cornea, oculovestibular)
N
Y
Y
Y
Y
Motor status better than flaccid
N
Y
Y
Y
Motor withdrawal
N
Y
Y
Verbal moans
N
Y
The outcome in each group is as follows:
Prediction of Outcome of Coma at 24 Hours
D or PVS
SD
MD or GR
Group 1
97%
2%
1%
Group 2
80%
8%
12%
Group 3
69%
14%
17%
Group 4
58%
19%
23%
Group 5
46%
13%
41%
To read more or access our algorithms and calculators, please log in or register.
