Calc Function

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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    GCS-Pupils Score

    Combines GCS and pupil reactivity for greater accuracy at low GCS.
    When to Use
    Pearls/Pitfalls

    Patients with traumatic brain injury.

    • Retrospectively derived, based on pooled data from two large databases, IMPACT and CRASH. 
    • Addition of pupil data was shown to be particularly useful at very low GCS scores (3-4), likely because of higher frequency of abnormal pupil response in patients with severe TBI and low GCS (Brennan 2018).
    Eyes open spontaneously
    +4
    Eye opening to verbal command
    +3
    Eye opening to pain
    +2
    No eye opening
    +1
    Not assessable (trauma, edema, etc)
    +1
    Oriented
    +5
    Confused
    +4
    Inappropriate words
    +3
    Incomprehensible sounds
    +2
    No verbal response
    +1
    Intubated
    +1
    Obeys commands
    +6
    Localizes pain
    +5
    Withdrawal from pain
    +4
    Flexion to pain
    +3
    Extension to pain
    +2
    No motor response
    +1
    Both pupils unreactive to light
    -2
    One pupil unreactive to light
    -1
    Both pupils reactive to light (normal)
    0

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Paul M. Brennan

    About the Creator

    Paul M. Brennan, FRCS, FRCSEd, MRCS, PhD, is a senior lecturer in neurosurgery at the University of Edinburgh in Scotland, UK. He is also an honorary consultant neurosurgeon at NHS Lothian. Dr. Brennan’s primary research is focused on management of brain tumors and enhancing the use of the Glasgow Coma Scale.

    To view Dr. Paul M. Brennan's publications, visit PubMed

    Are you Dr. Paul M. Brennan? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Dr. Graham Teasdale

    About the Creator

    Sir Graham Teasdale, MBBS, is an honorary professor at the Institute of Health and Wellbeing, University of Glasgow. He was previously the professor of neurosurgery, head of the department of neurosurgery, and associate dean for medical research at the University of Glasgow. Sir Teasdale was also the president of the Royal College of Physicians and Surgeons of Glasgow (2003-2006), and was knighted in 2006 for his services to neurosurgery.

    To view Dr. Graham Teasdale's publications, visit PubMed

    Are you Dr. Graham Teasdale? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Paul M. Brennan
    Are you Dr. Paul M. Brennan?
    Dr. Graham Teasdale
    Are you Dr. Graham Teasdale?