The Glasgow Coma Scale

Cook, Neal F.

doi:10.1016/j.cnc.2020.10.005

Cited by 19 publications

(7 citation statements)

References 22 publications

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“…In this step, we mainly depend on medical expert opinions in specifying the most important features that could contribute to predict GCS and assure the ability of predicting GCS from vital signs. As mentioned before, GCS is a medical score that used to specify the consciousness of the patient through three main measures: verbal response, eye opening and motor response [88,89]. These measurements are highly correlated with changing in patient's vital signs.…”

Section: Feature Extractionmentioning

confidence: 99%

An efficient edge/cloud medical system for rapid detection of level of consciousness in emergency medicine based on explainable machine learning models

El-Rashidy

Sedik

Siam

et al. 2023

Neural Comput & Applic

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Emergency medicine (EM) is one of the attractive research fields in which researchers investigate their efforts to diagnose and treat unforeseen illnesses or injuries. There are many tests and observations are involved in EM. Detection of the level of consciousness is one of these observations, which can be detected using several methods. Among these methods, the automatic estimation of the Glasgow coma scale (GCS) is studied in this paper. The GCS is a medical score used to describe a patient’s level of consciousness. This type of scoring system requires medical examination that may not be available with the shortage of the medical expert. Therefore, the automatic medical calculation for a patient’s level of consciousness is highly needed. Artificial intelligence has been deployed in several applications and appears to have a high performance regarding providing automatic solutions. The main objective of this work is to introduce the edge/cloud system to improve the efficiency of the consciousness measurement through efficient local data processing. Moreover, an efficient machine learning (ML) model to predict the level of consciousness of a certain patient based on the patient’s demographic, vital signs, and laboratory tests is proposed, as well as maintaining the explainability issue using Shapley additive explanations (SHAP) that provides natural language explanation in a form that helps the medical expert to understand the final prediction. The developed ML model is validated using vital signs and laboratory tests extracted from the MIMIC III dataset, and it achieves superior performance (mean absolute error (MAE) = 0.269, mean square error (MSE) = 0.625, R2 score = 0.964). The resulting model is accurate, medically intuitive, and trustworthy.

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Section: Feature Extractionmentioning

confidence: 99%

An efficient edge/cloud medical system for rapid detection of level of consciousness in emergency medicine based on explainable machine learning models

El-Rashidy

Sedik

Siam

et al. 2023

Neural Comput & Applic

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“…e higher the score, the more serious the neurological damage of the patient. [14] was used to evaluate the coma degree of patients, including eye opening, language, and exercise, with a full score of 15. e lower the score, the more severe the coma.…”

Section: Assessment Of the Degree Of Neurological Deficitmentioning

confidence: 99%

A Retrospective Cohort Study of Neuroendoscopic Surgery versus Traditional Craniotomy on Surgical Success Rate, Postoperative Complications, and Prognosis in Patients with Acute Intracerebral Hemorrhage

Yang

Zhou

Lai

et al. 2022

Computational Intelligence and Neuroscience

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Objective. A case-control study was adopted to explore the effect of neuroendoscopy compared with traditional craniotomy on the success rate, postoperative complications, and prognosis of patients with intracerebral hemorrhage (ICH). Methods. The clinical data of 106 patients with ICH treated in our hospital from March 2019 to June 2021 were collected and analyzed retrospectively and divided into two groups according to different treatment methods. The patients who were cured by craniotomy were in the control group (n = 53), and those who received neuroendoscopic surgery were in the research group (n = 53).The clinical efficacy of patients was compared, and the cognition and daily living ability were evaluated by the Trier cognitive assessment scale, limb motor function score, and activity of daily living scale. The National Institutes of Health Stroke scale (NIHSS) and Glasgow coma scale (GCS) were used to compare the neurological function of the two groups before and after treatment, and the Glasgow outcome scale (GOS) and disability rating scale (DRS) were adopted to evaluate the functional prognosis. The simplified Fugl-Meyer motor function score was adopted to evaluate the patient’s limb function, the Montreal cognitive assessment scale was adopted to evaluate the patient’s cognitive function, the Barthel index score was adopted to evaluate the daily living ability of patients, and the treatment of patients was recorded. Results. In comparison with groups, the effective rate of treatment in the research group was higher, and the difference between groups was statistically significant ( P < 0.05 ). Regarding the surgical indicators, the hospital stay, intraoperative blood loss, postoperative residual blood flow, and total hospital stay in the research group were remarkably lower, the hematoma clearance rate in the research group was remarkably higher, and the difference between groups was statistically significant( P < 0.05 ). After operation, the KPS scores indicated a gradual upward trend, and those of the research group were higher at 1 month, 2 months, and 3 months after operation. The Barthel index scores were compared. After treatment, the Barthel index scores increased. In comparison with the two groups, the Barthel index scores of the research group were higher at 1 month, 2 months, and 3 months after surgery, and the difference between groups was statistically significant ( P < 0.05 ). The NIHSS, GCS, and DRS scores were compared. After treatment, the NIHSS, GCS, and DRS scores were decreased. In comparison with the two groups, the NIHSS, GCS, and DRS scores of the research group were remarkably lower, and the difference between groups was statistically significant ( P < 0.05 ). With regard to the cognitive and physical function recovery after treatment, the MoCA score and Fugl-Meyer score of the research group were remarkably higher, and the difference between groups was statistically significant( P < 0.05 ). The quality of life scores was compared. After treatment, the quality of life scores decreased. In comparison with the two groups, the scores of physiological function, psychological function, social function, and healthy self-awareness of the research group were lower, and the difference between groups was statistically significant ( P < 0.05 ). The incidence of postoperative complications in the research group was significantly lower than that in the control group, and the difference between groups was statistically significant ( P < 0.05 ). Conclusion. Compared with conventional craniotomy, neuroendoscopic surgery can remarkably reduce the operation time and blood loss, enhance the hematoma clearance rate, and have a better prognosis, which is more conducive to the recovery of postoperative neurological function, life activities, and quality of life of patients.

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“…We hypothesize that the vast majority of patients with low-mechanism closed head trauma who receive direct oral anticoagulant without abnormal initial cephalic CT findings will not have a late intracranial rebleed and, in fact, will not benefit from a prolonged hospital stay or repeat imaging [12]. Indications: Some guidelines state that simple CT should be performed in patients with moderate or severe trauma (GSC <13) due to the higher incidence of acute intracranial hemorrhage, however different studies have shown that from 16% to 21% of patients with GCS 13 to 15 have acute intracranial hemorrhage so the CT scan should be performed [13]. Skull fractures, hemorrhages, bruises, or cerebral edema, commonly determine the impact of the lesions on adjacent brain tissue (the mass effect, the compressed ventricle), as well as the extent and location of the injuries [6].…”

Section: Computed Tomographymentioning

confidence: 99%

“…Biochemical alterations due to neural structural deformation caused by TBI imbalances neurotransmitters release that can affect the cellular sodium-potassium (Na + -K + ) pump and results in distribution of membrane homeostasis [34]. The advantage of this imaging tool is to allow correlation with the functional outcome by 6 months after TBI [13]. Recent meta-analysis showed that significant changes in the ratios NAA / Creatinine and Choline / Creatinine and in the absolute values of NAA are associated with clinical outcome in TBI [35].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Acute phase of traumatic brain injury

Bolaño-Romero,

Gaitan-Herrera,

Galarza-Garrido

et al. 2022

roneuro

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In neurotrauma, diagnostic imaging plays a fundamental role in the early detection of treatable injuries or the mitigation of secondary injuries. Currently, the routine imaging techniques used in the setting of a head trauma patient include non-contrast computed tomography (CT), computed tomography angiography (CTA), conventional magnetic resonance imaging (MRI) with T1, T2 or diffusion imaging. Of the above mentioned, CT is superior to MRI in terms of speed of examination, due to the greater access to portable equipment in the patient's environment, which reduces the risk of secondary complications at the time of transfer to the radiology department. Nevertheless, MRI provides a much higher quality of images than CT. MRI is not indicated for the diagnosis of acute brain injury, but if the results of CT without contrast are normal, and neurological manifestations are present, it is indicated. As a result, CT should be the first study requested to the imaging service by the medical team in charge of the patient during the acute phase of the traumatic brain injury. The main objective of this review is to present some of the advantages and disadvantages offered by the different diagnostic imaging methods when approaching and managing brain-injured patients, with emphasis on the acute phase of trauma.

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The Glasgow Coma Scale

Cited by 19 publications

References 22 publications

An efficient edge/cloud medical system for rapid detection of level of consciousness in emergency medicine based on explainable machine learning models

An efficient edge/cloud medical system for rapid detection of level of consciousness in emergency medicine based on explainable machine learning models

A Retrospective Cohort Study of Neuroendoscopic Surgery versus Traditional Craniotomy on Surgical Success Rate, Postoperative Complications, and Prognosis in Patients with Acute Intracerebral Hemorrhage

Acute phase of traumatic brain injury

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