|
Prognosis of a comatose patient |
|
| Primary assessment |
|
| Glasgow Coma Scale <8? |
Patient is comatose |
| No response to environment? |
|
| At 24 hours |
|
| Clinical examination |
|
| Absent pupillary response? |
Probability of a poor outcome, 97% |
| Absent motor response? |
Probability of a poor outcome, 97% |
| Somatosensory evoked potentials, absent N20 signal bilaterally |
Probability of a poor outcome, 100% |
| Serum neuron-specific enolase ≥33 μg/l |
Probability of a poor outcome, 100% |
| At 72 hours |
|
| Clinical examination |
|
| Absent motor response? |
Probability of a poor outcome, 97% |
| Somatosensory evoked potentials, absent N20 signal bilaterally |
Probability of a poor outcome, 100% |
| Serum neuron-specific enolase ≥33 μg/l |
Probability of a poor outcome, 100% |
| Electroencephalography, isoelectric or burst-suppression |
Probability of a poor outcome, 100% |
|
'Poor outcome' is defined as death or persistent coma 1 month later [5,13]. | |
Meyer and Hall Critical Care 2006 10:223 doi:10.1186/cc4980 |
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