Doctors Use Patients’ Pupils as Windows Into Comas

(CN) – A new evaluation system could allow doctors to quickly determine levels of consciousness in people with brain injuries, according to a study published Tuesday in the Journal of Neurosurgery.

The report describes a modified version of the Glasgow Coma Scale (GCS), a 13-point scale created at the University of Glasgow in 1974.

With the new scale, doctors could be able to assess the health of a patient’s central nervous system in cases of intensive care or serious trauma. It could also improve the way doctors care for patients in a coma caused by a brain injury.

The GSC measures a patient’s ability to open his or her eyes, speak and move.

The team behind the test joined forces with researchers at the University of Edinburgh to modify the scale by adding a simple score for pupil response.

Using health records from more than 15,000 patients, the team showed that the new score, labeled GCS-Pupil (GCS-P), would have boosted doctors’ ability to predict a patient’s conditions within six months of a brain injury.

There are nearly 350,000 hospital admissions involving damage to the brain in the United Kingdom each year, equating to about one admission every 90 seconds.

“The importance of the Glasgow Coma Scale to medicine cannot be overstated and our simple revision really improves its predictive ability and usefulness,” said co-lead author Paul Brennan, a researcher at the University of Edinburgh.

“Making major decisions about brain-injured patients relies on quick assessments and the new method gives us rapid insights into the patient’s condition. Our next step is to test the GCS-P more widely on large data sets from Europe and the U.S.”

Sir Graham Teasdale, emeritus professor of neurosurgery at the University of Glasgow, touted the promise of the new scale.

“This has been a very successful collaboration. It promises to add a new index to the language of clinical practice throughout the world,” said Teasdale, who co-led the study. The GCS-P will be a platform for bringing together clinical information in a way that can be easily communicated and understood.”

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