[An uni-dimensional ordinal coma scale].

Abstract

With the introduction and wide acceptance of the Glasgow coma scale, some progress was made in 1980s. Various types of coma scale were offered from different centers of the world for assessing coma and impaired consciousness. The existing coma scales may be divided into two main categories: (1) multi-dimensional scale, e.g., Glasgow coma scale (GCS), Glasgow-Liege coma scale (G-LCS), Maryland coma scale (MCS); and (2) uni-dimensional scale, e.g., Edinburgh-2 coma scale (E2CS). There is evidence that the uni-dimensional coma scale is better than the multi-dimensional coma scale. The major drawbacks in the multi-dimensional coma scale is the total figure of coma level must be envisaged stereographially. The sum of scores of three dimensions of GCS, as in a multi-dimensional scale, consists of 13 levels from 3 through 15, but the numbers of simple combination constituting each score are considerable. No. 9 in GCS scale may be made up of 18 combinations. E2CS, as an uni-dimensional scale, seems to be an improvement over GCS. On the basis of comparison between two main categories of coma scale and considering the shortcomings of E2CS, a modified uni-dimensional ordinal coma scale called "Chengdu-1 Coma scale" (C1CS) was proposed and applied for evaluating the depth of coma and for prognosticating the patients' outcome. This study was based on 98 acutely head-injured patients treated in the Neurosurgical department of 1st Affiliated Hospital of WCUMS, from October 1983 through May 1984. The follow-up results showed that a good correlation was observed between the score of C1CS and the outcome scale score (Glasgow outcome scale, GOS) of the patients.