Pupil Evaluation and Glasgow Coma Scale
Susan Schmunk, CSTR, CAISS
A retrospective cohort analysis of data of 51,425 severely injured patients in the Trauma Registry of the German Society for Trauma Surgery from 1993 to 2009 was undertaken and the results published in the British Journal of Surgery in 2012. (Br J Surg. 2012 Jan;99 Suppl 1:122-30. doi: 10.1002/bjs.7707). The premise of this study was that “early diagnosis and prediction of traumatic brain injury (TBI) is essential for determining treatment strategies and allocating resources.” Of the over 51,000 total patients reviewed 24,115 patients met the studies inclusion criteria which were, directly admitted live patients who had complete data on GCS, pupil size and pupil reactivity.
This study concluded that the “The best predictive accuracy for presence of TBI was obtained using the GCS components. Pupil reactivity together with the GCS motor component performed best in predicting death.”