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[Value of Glasgow-Pittsburgh Coma Scale scoring in childhood coma]
Ying-Zhong He1, Zhi-Ping Wang, Jie Wang
1Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
Insights
Glasgow-Pittsburgh Coma Scale (GCS-P) scoring effectively predicts coma prognosis in children. Dynamic GCS-P curves, combined with EEG and imaging, improve predictive accuracy for better patient outcomes.
Area of Science:
- Pediatric Neurology
- Neurocritical Care
- Prognostic Biomarkers
Context:
- Coma in children presents diagnostic and prognostic challenges.
- Accurate prognosis is crucial for guiding treatment and resource allocation.
- Existing scales require further validation in pediatric populations.
Purpose:
- To evaluate the predictive value of the Glasgow Coma Scale (GCS) and Glasgow-Pittsburgh Coma Scale (GCS-P) for coma prognosis in pediatric patients.
- To assess the incremental value of combining GCS-P scoring with electroencephalogram (EEG) and neuroimaging findings.
Summary:
- A retrospective review of 17 comatose children analyzed GCS and GCS-P scores, EEG, and cranial imaging.
- GCS-P scoring demonstrated higher predictive accuracy (88.57%) compared to GCS (85.71%).
- Dynamic GCS-P curves correlated with prognosis: ascending curves indicated good outcomes, while flat or declining curves suggested poor outcomes.
Impact:
- GCS-P scoring is a valuable tool for predicting coma prognosis in children.
- Integration of GCS-P with EEG and neuroimaging enhances prognostic accuracy.
- This study supports the use of GCS-P for improved clinical decision-making in pediatric coma management.
Objective:
To investigate the value of Glasgow Coma Scale (GCS) and Glasgow-Pittsburgh Coma Scale (GCS-P) scoring in predicting the prognosis of coma in children.
Methods:
Clinical data of 17 comatose children were retrospectively reviewed. The results of GCS and GCS-P scoring, electroencephalogram (EEG) and cranial imaging were analyzed. Dynamic curves of GCS-P score were drawn.
Results:
Seven patients received EEG examination and four showed low potential. The four patients had poor prognosis. Cranial CT and MRI were performed in 12 patients. Of these three showed cerebral hemorrhage and ischemia and had a poor prognosis. The accuracy rate for predicting the prognosis of GCS and GCS-P scoring was 85.71% and 88.57% respectively. A continuous GCS-P scoring was performed in 13 patients. A dynamic GCS-P curve showed an ascent in seven cases with good prognosis but a flat or declined tendency in six cases with poor prognosis.
Conclusions:
GCS-P scoring is valuable for predicting prognosis in children with coma. Combined with EEG and cranial imaging examinations, the accuracy for predicting prognosis of GCS-P scoring will increase.
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