The Glasgow Coma Scale at 40 years: Standing the test of time

Graham Teasdale, Andrew Maas, Fiona Lecky, Geoffrey Manley, Nino Stocchetti, Gordon Murray

Research output: Contribution to journalArticle

Abstract

Since 1974, the Glasgow Coma Scale has provided a practical method for bedside assessment of impairment of conscious level, the clinical hallmark of acute brain injury. The scale was designed to be easy to use in clinical practice in general and specialist units and to replace previous ill-defined and inconsistent methods. 40 years later, the Glasgow Coma Scale has become an integral part of clinical practice and research worldwide. Findings using the scale have shown strong associations with those obtained by use of other early indices of severity and outcome. However, predictive statements should only be made in combination with other variables in a multivariate model. Individual patients are best described by the three components of the coma scale; whereas the derived total coma score should be used to characterise groups. Adherence to this principle and enhancement of the reliable practical use of the scale through continuing education of health professionals, standardisation across different settings, and consensus on methods to address confounders will maintain its role in clinical practice and research in the future.

Original languageEnglish
Pages (from-to)844-854
Number of pages11
JournalThe Lancet Neurology
Volume13
Issue number8
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Clinical Neurology

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