TY - JOUR
T1 - A simple and useful coma scale for patients with neurologic emergencies
T2 - The Emergency Coma Scale
AU - Takahashi, Chiaki
AU - Okudera, Hiroshi
AU - Origasa, Hideki
AU - Takeuchi, Eiichi
AU - Nakamura, Kazuhito
AU - Fukuda, Osamu
AU - Date, Isao
AU - Tokutomi, Takashi
AU - Aruga, Tohru
AU - Sakamoto, Tetsuya
AU - Kobata, Hitoshi
AU - Ohta, Tomio
N1 - Funding Information:
This trial was supported by the ECS Society, which is a joint committee of the Japanese Congress on Neurosurgical Emergencies and the Japan Neurological Emergency Society.
PY - 2011/2
Y1 - 2011/2
N2 - Objectives: The Emergency Coma Scale (ECS) was developed in Japan in 2003. We planned a multicenter study to evaluate the utility of the ECS by comparison of the ECS and the Glasgow Coma Scale (GCS). Methods: Ten medical facilities, including 4 university hospitals in Japan, participated in this study. We evaluated and recorded the level of consciousness, using the ECS and GCS, of all patients transported to these medical facilities by ambulance. We then performed a statistical analysis of the level of rater agreement of each scale using the average weighted κ coefficient according to the types of diagnosis at time of discharge and the occupations of the raters. We then evaluated the relationship between outcome of patients and their scores on the ECS and GCS by logistic regression analysis. Results: The ECS showed the greater agreement among raters in patient scoring (0.802). In patients with traumatic brain injury and cerebrovascular disease, the ECS also yielded the higher agreement (0.846 and 0.779, respectively). The ECS score appears to be more strongly related than the GCS to patient outcome as measured by the Glasgow Outcome Scale (GOS). Conclusions: Our results showed that the ECS is a simple and readily understandable coma scale for a wide range of professionals in the field of neurologic emergencies. Furthermore, ECS appears to be suitable for evaluating patients in neurologic emergency settings.
AB - Objectives: The Emergency Coma Scale (ECS) was developed in Japan in 2003. We planned a multicenter study to evaluate the utility of the ECS by comparison of the ECS and the Glasgow Coma Scale (GCS). Methods: Ten medical facilities, including 4 university hospitals in Japan, participated in this study. We evaluated and recorded the level of consciousness, using the ECS and GCS, of all patients transported to these medical facilities by ambulance. We then performed a statistical analysis of the level of rater agreement of each scale using the average weighted κ coefficient according to the types of diagnosis at time of discharge and the occupations of the raters. We then evaluated the relationship between outcome of patients and their scores on the ECS and GCS by logistic regression analysis. Results: The ECS showed the greater agreement among raters in patient scoring (0.802). In patients with traumatic brain injury and cerebrovascular disease, the ECS also yielded the higher agreement (0.846 and 0.779, respectively). The ECS score appears to be more strongly related than the GCS to patient outcome as measured by the Glasgow Outcome Scale (GOS). Conclusions: Our results showed that the ECS is a simple and readily understandable coma scale for a wide range of professionals in the field of neurologic emergencies. Furthermore, ECS appears to be suitable for evaluating patients in neurologic emergency settings.
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U2 - 10.1016/j.ajem.2009.09.018
DO - 10.1016/j.ajem.2009.09.018
M3 - Article
C2 - 20825789
AN - SCOPUS:78751673778
VL - 29
SP - 196
EP - 202
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
SN - 0735-6757
IS - 2
ER -