Abstract
Validation of the Simplified Motor Score in the Out-of-Hospital Setting for the Prediction of Outcomes After Traumatic Brain Injury
The Glasgow Coma Scale (GCS) is used quantify a patient's conscious state during communication between medical providers; however, it has been criticized for its complexity and poor interrater reliability. The 3-point Simplified Motor Score (SMS)—defined as “obeys commands” = 2, “localizes pain” = 1, “withdraws to pain or worse” = 0—was created to simplify the GCS score and has a greater interrater reliability. 1
This study performed a secondary analysis of a 19,408-patient trauma registry to validate the SMS for predicting outcomes after traumatic brain injury. The 4 outcomes were emergency tracheal intubation, clinically significant brain injury, need for neurosurgical intervention, and mortality. By comparing areas under the receiver operating characteristic curve, it was found that the SMS was equally effective as the GCS score for predicting traumatic brain injury outcomes in the out-of-hospital setting. The authors recognize the need for further research and acknowledge that changing from GCS to SMS presents many systematic challenges, such as retraining medical providers.
(Ann Emerg Med. 2011;58:417–425). D Thompson, T Hurtado, M Liao, et al
Prepared by Matthew Stewart, MD, University of Utah Emergency Medicine Resident, Salt Lake City, UT, USA