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Irish Journal of Medical Science

, Volume 181, Issue 1, pp 77–80 | Cite as

Correlation between BIS and GCS in patients suffering from head injury

  • M. Ebtehaj
  • S. Yaqubi
  • A. S. Seddighi
  • A. SeddighiEmail author
  • Z. Yazdi
Original Article

Abstract

Objectives and background

Glasgow coma scale (GCS) is considered an important parameter to predict the clinical outcome in head injury; however, in some cases such as the use of sedative drugs the estimate of GCS would not be precise. Bispectral index (BIS) is an electrophysiological parameter to determine the clinical state of anesthesia. The aim of the present study is to evaluate correlation between GCS and BIS in patients suffering from head injury and to see if we can use BIS values as a prognostic factor in head trauma.

Methods

In this analytic study 61 consecutive patients with traumatic head injury admitted to the intensive care unit from January till June 2010 were examined. In each case the GCS and BIS values were measured and compared regarding different degrees of head injuries.

Results

Mean BIS in mild injury group was 96.20 ± 3.27 and in moderate injury group was 45.57 ± 1.28 and in severe injury group was 31.37 ± 2.08. There was a significant correlation between GCS and mean BIS (r = 0.88; P < 0.05). Mean BIS values were significantly different between mild, moderate and severe head injuries (96.2 ± 3.2, 45.5 ± 1.2, and 31.3 ± 2.08, respectively; P < 0.05).

Conclusion

We found significant correlation between GCS and BIS in patients with traumatic head injury, so BIS can be used in addition to GCS for prediction of outcome in these patients specially in patients who are sedated or are intubated or in other case in whom GCS values cannot be determined accurately.

Keywords

Head trauma GCS BIS Prognosis 

Notes

Conflict of interest

None.

References

  1. 1.
    Gill M, Green SM, Krauss B (2003) Can the bispectral index monitor quantify altered level of consciousness in emergency department patients? Acad Emerg Med 10:175–179PubMedCrossRefGoogle Scholar
  2. 2.
    Hamel MB, Phillips R, Teno J et al (2002) Cost effectiveness of aggressive care for patients with non traumatic coma. Crit Care Med 30:1191–1196PubMedCrossRefGoogle Scholar
  3. 3.
    Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness: a practical scale. Lancet 2:81–84PubMedCrossRefGoogle Scholar
  4. 4.
    Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. Lancet 1:480–484PubMedCrossRefGoogle Scholar
  5. 5.
    Owen AM, Menon DK, Johnsrude IS et al (2002) Detecting residual cognitive function in persistent vegetative state. Neurocase 8:394–403PubMedCrossRefGoogle Scholar
  6. 6.
    Simmons LE, Riker RR, Prato BS et al (1999) Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale. Crit Care Med 27:1499–1504PubMedCrossRefGoogle Scholar
  7. 7.
    Gilbert TT, Wagner MR, Halukurike V et al (2001) Use of bispectral electroencephalogram monitoring to assess neurologic status in unsedated, critically ill patients. Crit Care Med 29:1996–2000PubMedCrossRefGoogle Scholar
  8. 8.
    Keene AR, Cullen DJ (1983) Therapeutic intervention scoring System: update 1983. Crit Care Med 11:1–3PubMedCrossRefGoogle Scholar
  9. 9.
    Arefian N, Seddighi AS, Seddighi A (2007) Clinical analysis of eeg parameters in prediction of the depth of anesthesia in different stages: a comparative study. Internet J Anesthesiol 19(1)Google Scholar
  10. 10.
    Haug E, Miner J, Dannehy M et al (2004) Bispectral electroencephalographic analysis of head-injured patients in the emergency department. Acad Emerg Med 11:349–352PubMedGoogle Scholar
  11. 11.
    Fabregas N, Gambus PL, Valero R et al (2004) Can bispectral index monitoring predict recovery of consciousness in patients with severe brain injury? Anesthesiology 101:43–51PubMedCrossRefGoogle Scholar
  12. 12.
    Rosow C, Manberg PJ (2001) Bispectral index monitoring. Anesthesiol Clin N Am 19(4):947–966CrossRefGoogle Scholar
  13. 13.
    De Deyne C, Struys M, Decruyenaere J et al (1998) Use of continuous bispectral EEG monitoring to assess depth of sedation in ICU patients. Intensive Care Med 24:1294–1298PubMedCrossRefGoogle Scholar
  14. 14.
    Paul DB, Umamaheswara Rao GS (2006) Correlation of bispectral index with Glasgow coma score in mild and moderate head injuries. J. Of Clin. Monit Comput 20(6):399–404CrossRefGoogle Scholar
  15. 15.
    Vivien B, Paqueron X, Le Cosquer P et al (2002) Detection of brain death onset using the bispectral index in severely comatose patients. Intensive Care Med 28:419–425PubMedCrossRefGoogle Scholar
  16. 16.
    Pandit JJ, Schmelzle-Lubiecki B, Goodwin M et al (2002) Bispectral index—guided management of anaesthesia in permanent vegetative state. Anaesthesia 57:1190–1194PubMedCrossRefGoogle Scholar
  17. 17.
    Prins SA, de Hoog M, Blok JH et al (2007) Continuous non-invasive monitoring of barbiturate coma in critically ill children using the bispectral index monitor. Crit Care 11:108CrossRefGoogle Scholar
  18. 18.
    Ellenberger C, Diaper J, Licker M et al (2007) Bispectral index and detection of acute brain injury during cardiac surgery. Eur J Anaesthesiol 24:807–809PubMedCrossRefGoogle Scholar
  19. 19.
    Guignard B, Menigaux C, Dupont X et al (2000) The effect of remifentanil on the bispectral index change and haemodynamic responses after orotracheal intubation. Anesth Analg 90:161–167PubMedCrossRefGoogle Scholar
  20. 20.
    Casati L, Fernández Galinski S, Barrera E et al (2002) Isoflurane requirements during combined general–epidural anesthesia for major abdominal surgery. Anesth Analg 94:1331–1337PubMedCrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2011

Authors and Affiliations

  • M. Ebtehaj
    • 1
  • S. Yaqubi
    • 1
  • A. S. Seddighi
    • 2
  • A. Seddighi
    • 1
    • 2
    • 3
    Email author
  • Z. Yazdi
    • 1
  1. 1.Shahid Rajaee HospitalQazvin University of Medical SciencesQazvinIran
  2. 2.Neurofunctional Research Center, Shohada Tajrish HospitalShahid Beheshti University of Medical SciencesTehranIran
  3. 3.TehranIran

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