Obiako Onyeadumarakwe Reginald, Ogunniyi Adesola
Coma due to acute stroke is a medical emergency requiring reliable tool(s) for prediction of its outcome. The limitations of the universally adopted Glasgow Coma Scale/Score (GCS) have prompted the development of other coma scales by neuroscientists and critical care workers. This study seeks to compare the predictive values of the GCS and a newly developed Brainstem Signs Score (BSS) to the outcome of coma in acute stroke patients. The depth and severity of coma in 66 acute stroke patients was scored simultaneously at presentation and then daily for a maximum of 28 days with both the GCS and BSS. The predictive score of each scoring system was determined by Wilcoxon Rank Sum/Mann – Whitney-U test. Predictive values of each system were then compared. The BSS had negative predictive values (NPVs) of 100% on initial evaluation up to the 28th day, and positive predictive values (PPVs) of 100% from the first to the 7th day, while the GCS produced NPVs of 100% from the 7th to the 28th days, and a PPV of 100% on the 7th day only. Its negative and positive values on initial evaluations were less than 80%. The BSS had both higher negative and positive predictive values than the GCS and, therefore, appears to be better in predicting outcome of coma in acute stroke patients.
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