Citation

Sánchez-Sánchez MM, Sánchez-Izquierdo R, Sánchez-Muñoz EI, Martínez-Yegles I, Fraile-Gamo MP, Arias-Rivera S. Enferm Intensiva 2014; 25(1): 15-23.

Vernacular Title

Fiabilidad interobservador de la escala del coma de Glasgow en pacientes críticos con enfermedad neurológica o neuroquirúrgica.

Affiliation

Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, España.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.enfi.2013.09.002

PMID

24308910

Abstract

INTRODUCTION: The Glasgow coma scale (GCS) is a common tool used for neurological assessment of critically ill patients. Despite its widespread use, the GCS has some limitations, as sometimes different observers may value differently the same response. OBJECTIVE: To evaluate the interobserver agreement, among intensive care nurses with a minimum of 3 years experience, both in the overall estimate of GCS and for each of its components. METHODS: Prospective observational study including 110 neurological and/or neurosurgical patients conducted in a critical care unit of 18 beds, from October 2010 until December 2012. Registered variables: Demographic characteristics, reason for admission, overall GCS and its components. The neurological evaluation was conducted by a minimum of 3 nurses. One of them applied an algorithm and consensual assessment technique and all, independently, valued response to stimuli. Interobserver agreement was measured using the intraclass correlation coefficient (ICC) for a confidence interval (CI) of 95%. The study was approved by the Ethics Committee for Clinical Trails. RESULTS: The intraclass correlation coefficient (confident interval) for scale was: Overall GCS: 0.989 (0.985-0.992); ocular response: 0.981 (0.974-0.986); verbal response: 0.971 (0.960-0.979); motor response: 0.987 (0.982-0.991). CONCLUSION: In our cohort of patients we observed a high level of consistency in the application of both the GCS as in each of its components.

Language: es