Does the Glasgow Coma Score Predict Outcome in Status Epilepticus?
Abstract number :
2.140
Submission category :
Year :
2001
Submission ID :
2198
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
A.R. Towne, M.D., Neurology, Virginia Commonwealth University, Richmond, VA; L.K. Garnett, RN, MSHA, Neurology, Virginia Commonwealth University, Richmond, VA; E.J. Waterhouse, M.D., Neurology, Virginia Commonwealth University, Richmond, VA; L.D. Morton,
RATIONALE: To determine the usefulness of the Glasgow Coma Score in predicting outcome in Status Epilepticus (SE).
METHODS: Data was obtained from the NIH Greater Richmond Metropolitan Area Status Epilepticus (SE) database. Standard Glasgow Coma score (GCS) forms were filled out for all cases, which includes scores for eye opening, motor and verbal responses. The first GCS recorded after SE ended was used in this study. Individual scores for eye opening, verbal and motor responses were combined to give one total score per case, ranging from 3 to 15. All cases with Glasgow Coma scores consistent with coma prior to SE, and patients who died in SE were excluded. Seizure type and SE etiolgy were examined, with some cases having multiple etiologies.
RESULTS: A total of 757 adult and pediatric cases were included in this study, with an overall mortality of 19%. Mortality by GCS was statistically significant (p[lt]0.0001), with highest mortality seen in the GCS 3 and GCS 4 groups. Distribution of GCS and mortality was as follows: 15.3% had a score of 3, with a mortality of 30%; 2.3 had a score of 4, with a mortality of 38.9%; 1% had a score of 5, with a mortality of 2%; 21.4% had a score of 6, with a mortality of 16.7%, 8.9% had a score of 7, with a mortality of 4.9%; 5% had a score of 8, with a mortality of 3.8%; 7% had a score of 9, with a mortality of 4.9%; 6.9% had a score of 10, with a mortality of 4.2%; 5.3% had a score of 11, with a mortality of 4.2%, 3.2% had a score of 12, with a mortality of 3.5%; 4% had a score of 13, with a mortality of .7%; 5.7% had a score of 14, with a mortality of 9.7%; and 14% had a score of 15, with a mortality of 11.1%. Mortality by etiology was as follows: 32.4% for CNS acute, 54.7% for hypoxia/anoxia, 14.3% for nonCNS acute, 7.6% for Remote, 7.3% for Withdraw and 5.9% for Other. Specific distribution of GCS score by etiology, and SE types in relation to mortality and to total GCS will be presented.
CONCLUSIONS: The Glasgow Coma Score can be a useful prognostic indicator in SE, and should be considered as part of the patient[ssquote]s initial evaluation.
Support: NIH P50NS25630.