Evaluation of coma: A critical appraisal of popular scoring systems

Joshua Kornbluth, Anish Bhardwaj

Research output: Contribution to journalReview article

40 Scopus citations

Abstract

Numerous scoring scales have been proposed and validated to evaluate coma for rapid pre-hospital assessment and triage, disease severity, and prognosis for morbidity and mortality. These scoring systems have been predicated on core features that serve as a basis for this review and include ease of use, inter-rater reliability, reproducibility, and predictive value. Here we review the benefits and limitations of the most popular coma scoring systems. The methods include search of Medline, databases, and manual review of article bibliographies. Few of the many available coma scales have gained widespread approval and popularity. The best known and widely accepted scale is the Glasgow Coma Scale (GCS). The Reaction Level Scale (RLS85) has utility and proven benefit, but little acceptance outside of Scandinavia. The newer Full Outline of UnResponsiveness (FOUR) score provides an attractive replacement for all patients with fluctuating levels of consciousness and is gradually gaining wide acceptance.

Original languageEnglish (US)
Pages (from-to)134-143
Number of pages10
JournalNeurocritical Care
Volume14
Issue number1
DOIs
StatePublished - Feb 1 2011

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Keywords

  • Coma
  • Consciousness
  • FOUR score
  • GCS
  • RLS85

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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