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In Reply: Dr Stockinger clarifies the difference between the Glasgow Coma Scale as originally described by Teasdale and Jennett¹ and its subsequent modification into the Glasgow Coma Score.² We agree that for intubated patients, it is most useful to describe the individual components of the Glasgow Coma Score rather than the total score. Unfortunately this is a limitation of the existing literature, for most primary studies in our review did not provide individual scores (ie, eyes, verbal, motor) but instead reported only the total score.

In our meta-analysis, we did not find the total Glasgow Coma Score to be useful in predicting outcome in comatose survivors of cardiac arrest. Accordingly, we do not recommend using this as a prognostic factor for this patient population. Rather, we suggested using individual physical findings (ie, absent withdrawal response to pain, absent corneal or pupil reflexes at 24 hours, and absent motor response at . . . [Full Text of this Article]

Christopher M. Booth, MD
christopher.booth@utoronto.ca

Allan Detsky, MD, PhD
Department of Medicine
University of Toronto

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