Background

Traumatic brain injury (TBI) necessitates prompt assessment of consciousness to guide critical interventions like intubation. While the Glasgow Coma Scale (GCS) is the standard tool, its complexity limits rapid use. Simplified scales like the Simplified Motor Scale (SMS) and Modified GCS Motor Response (mGCS-motor) offer practical alternatives. This study evaluates their effectiveness in predicting intubation and clinical outcomes.

Methodology

A cross-sectional observational study was conducted over 12 months at KVG Medical College, Sullia, involving 100 adult TBI patients. GCS, mGCS-motor, and SMS scores were recorded at admission. ROC analysis assessed predictive accuracy for intubation needs. Outcomes included morbidity, mortality, and hospital stay, with data analyzed using SPSS v27.

Results

Out of 100 TBI patients studied, 61% required intubation. The Total Glasgow Coma Scale (TGCS) demonstrated the highest predictive accuracy for intubation (AUC = 1.000), mortality (AUC = 0.991), morbidity (AUC = 0.766), and hospitalization duration (AUC = 0.915). The Modified GCS Motor Response (MGCS) also showed excellent prediction for intubation (AUC = 0.908) and mortality (AUC = 0.980), with fair performance for hospitalization duration (AUC = 0.837). The Simplified Motor Scale (SMS), though statistically significant in most outcomes, showed relatively lower predictive validity. Overall, TGCS remains the most reliable tool, with MGCS offering a practical alternative in emergency settings.

Conclusion