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May 19, 2004

Usefulness of the Glasgow Coma Score in Survivors of Cardiac Arrest

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(19):2313. doi:10.1001/jama.291.19.2313-a

To the Editor: In their Rational Clinical Examination article about predicting outcomes in comatose patients after cardiac resuscitation, Dr Booth and colleagues1 frequently discussed the Glasgow Coma Scale and the Glasgow Coma Score. We have several concerns about how the authors represented these instruments.

The original Glasgow Coma Scale contained no numerical values and did not distinguish between flexion-withdrawal and decorticate flexion.2 It therefore would have ranged from 3 to 14, had values been assigned. The Glasgow Coma Score, which the authors' Table 1 actually depicts, assigned numerical values to the scale and appeared in 1979.3 This ranges from 3 to 15, even in intubated patients. Teasdale and Jennett, who originated the scale, continue to maintain the distinction between the scale as a means to describe an individual patient and the score as a summary statistic or research tool and reaffirm that the score should be based on a total of 15.2,3

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