Prediction of neuropsychiatric outcome following mild trauma brain injury:an examination of the Glasgow Coma Scale

The relationship between the Glasgow Coma Scale (GCS) and neuropsychiatric outcome was examined in 57 consecutive subjects with mild traumatic brain i njury (TBI) attending a follow-up clinic. Subjects were grouped according t o initial GCS score (15 versus 13-14) and contrasted at an average of 5-6 m onths post-injury. As expected, those with GCS 13-14 had longer PTA (p = 0. 001) and a higher rate of abnormal brain CT scans (p = 0.005). However, no significant differences emerged for indices of neuropsychiatric status, inc luding measures of neurobehavioural symptoms/signs, overall psychological d istress, psychiatric 'caseness', functional and psychosocial outcome, frequ ency of common somatic complaints, and rate of return to work. Subsidiary a nalyses based upon the presence/absence of CT abnormalities and the duratio n of PTA (<1 hour versus 1-24 hours) also failed to predict outcome, althou gh a trend associating longer PTA with lower functional outcome was observe d. Thus, despite early neurosurgical differences, the results suggest that initial GCS scores do not clearly translate into neuropsychiatric sequelae at follow-up within the rubric of GCS 13-15.