VARIATION AMONG TRAUMA CENTERS CALCULATION OF GLASGOW COMA SCALE SCORE - RESULTS OF A NATIONAL SURVEY

Background: Glasgow Coma Scale (GCS) scoring is enigmatic in intubated patients. To determine if there is consensus among Level I trauma cen ters, a national telephone survey was conducted. Methods: Trauma regis trars at state-verified or American College of Surgeons-verified Level I trauma centers were questioned about GCS scoring, recording, and re porting in patients who are intubated or intubated and pharmacological ly paralyzed, Results: Seventy-three centers were contacted. Seventy-o ne use initial GCS scores for registry recording. Intubated patients a re given 1 point for verbal component plus eye and motor scores at 26% of centers and a total GCS score of 3 at 23%; GCS score is estimated with ''T'' given for verbal component at 16%, scored as unknown at 10% , always scored as 15 at 10%, and the method of scoring is unknown at 15%, Pharmacologically paralyzed intubated patients are given a total GCS score of 3 at 34%, GCS score is estimated with ''T'' given for ver bal component at 18%, patients are given 1 point for verbal component plus eye and motor scores at 12%, scored as unknown at 11%, always sco red as 15 at 8%, and the method of scoring is unknown at 16%, Conclusi on: Wide variation in GCS scoring among Level I trauma centers was ide ntified. Because GCS scores are used in treatment algorithms, trauma s coring, and outcome prediction (Trauma and Injury Severity Score), uni form scoring is essential and should be pursued. Use of state and nati onal databases and outcome research may be adversely affected by the l ack of consistent GCS scoring.