Comparison between the Glasgow Coma Scale and Simplified Motor Score as a Tools to Predict Outcome for Adult Stroke Patients

Koo,  Do Hyun; Cho,  Yong Chul; Oh,  Se Kwang; Ryu,  Seung; Lee,  Jin Woong; Kim,  Seung Whan; Yoo,  In Sool; You,  Yeon Ho

J Korean Soc Emerg Med > Volume 20(1); 2009 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2009;20(1): 95-100.

Comparison between the Glasgow Coma Scale and Simplified Motor Score as a Tools to Predict Outcome for Adult Stroke Patients

Do Hyun Koo, Yong Chul Cho, Se Kwang Oh, Seung Ryu, Jin Woong Lee, Seung Whan Kim, In Sool Yoo, Yeon Ho You

¹Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. emfire@cnuh.co.kr
²Department of Emergency Medicine, College of Medicine, Konyang University, Daejeon, Korea.

ABSTRACT

PURPOSE:
We wanted to evaluate the utility of the Simplified Motor Score (SMS) for prediction of outcome for adult stroke patients.
METHODS:
This was a prospective study of adult stroke patients from May to October, 2007. Emergency medicine residents independently checked the Glasgow Coma Scale (GCS) for each patient at the same time that interns otherwise, senior medical students (MS) and nurses checked the 3-point SMS within 5 minutes of patients arrival at our emergency care center. We telephoned the patients or their families to inform them of intubation, or death and to check the cerebral performance category (CPC) on the first- day and- first month after the patients' visits.
RESULTS:
Fifty-eight patients were enrolled in this study. Each SMS of evaluation by interns, MS and nurses was correlated with GCS (Correlation Coefficient=0.63, 0.59, 0.61; p<0.01, respectively). In the case of mortality within 24 hours, the AUC (area under the curve) for GCS was 0.46 and the AUCs for SMS of interns, MS and nurses were 0.94, 0.94, and 0.94. In the case of intubation within 24 hours, the AUC for GCS was 0.81 and the AUCs for SMS of interns, MS and nurses were 0.78, 0.79, and 0.77. In the case of CPC at one month, the AUC for GCS was 0.82 and the AUCs for SMS of interns, MS and nurses were 0.74, 0.75, and 0.73, respectively.
CONCLUSION:
The accuracy of SMS was equal to that of GCS for predicting outcome for adult stroke patients in such parameters as mortality, intubation and CPC.

Key words: Severity of illness index, Stroke, Glasgow coma scale