Pediatric Facial Trauma: Glasgow Coma Scale as a Predictor of Complications

Abstract

There has been much debate about the utility of the Glasgow Coma Scale (GCS) in terms of predicting outcomes of pediatric trauma. While some studies state GCS can reliably predict mortality outcomes, others have stated that its dependence on verbal responses and interobserver discrepancy limit its application. In pediatric facial trauma, there is a relative lack of variables that predict functional outcomes. Applying GCS to this patient cohort may elucidate its role in this patient population and possible inclusion in a patient’s treatment decisions. This retrospective examination uses a multi-center database to evaluate pediatric (<18 years old) facial trauma patients (N = 1094) visiting 2 level-one trauma centers from 2020 to 2022. The number of complications, consultations, moderate and significant physical impairments, number of surgical interventions, and deaths were compared to the GCS score, number of soft tissue injuries and fractures, and length of hospital stay. For both AHCMC and AHWFB, a lower GCS score was the factor that most strongly correlated to post-trauma complications, significant physical impairment, and deaths (P < .001). Acknowledging the correlation the GCS score has with outcomes can help guide healthcare decisions and expectations by informing patients and their families of potential complications based on their initial post-trauma status.