GCS Scores and Encephalopathy

evanspx@sutterhealth.org

Does anyone have any medical literature that will definitively provide and cite corresponding GCS scores that are used to provide evidence and support for ‘encephalopathy’. I know the clinical definition for encephalopathy, and I understand that GCS scores of 8 or so are commonly used for the condition of ‘coma’.  Can GCS scores be used with precision to diagnosis (and defend the diagnosis) of encephalopathy?  Thanks!

Paul Evans, RHIA, CCDS

lprescott1

interesting question paul- I have never seen anything like that. I think it would be difficult as encephalopathy can present in varied ways. The patient may be lethargic and slow to respond, or may be hyperconfused and agitated.

afrady@blr.com

AS far as I am aware, GSC scores and a dx of encephalopathy do not cross walk.  A low score may support clinically validity of an encephalopathy diagnosis of course, if it were of CNS origin or one of the chronic progressive types etc. I would not think it to assign a GSC score appropriate with something as transient as hypoglycemic/hypertensive/transient hypoxic and some of the metabolic's unless they were also in the ICU with a catastrophic neurological problem of a multi factorial nature.  I also would not think a GSC would be appropriate in something like an end stage alzhiemers patient who's presentation was pre-existing and they just happened to be in the ICU.

evanspx@sutterhealth.org

Thank you for the thoughtful responses. I should have clarified I am referring to forms of encephalopathy that would be of acute onset in the setting of something such as sepsis. I agree with the points made - particularly the different presentations seen with different types of encephalopathy. I was weakly optimistic I had overlooked some type of clinical cross walk for this subjective condition. Paul