Prehospital versus Emergency Department Glasgow Coma Scale in Blunt Traumatic Brain Injury: A Retrospective Review of the National Trauma Data Bank.

This article focuses on comparing prehospital (PH) and emergency department (ED) Glasgow Coma Scale (GCS) scores in adults with blunt traumatic brain injuries (TBIs) using data from the National Trauma Data Bank. The study of 419,145 patients found substantial overall agreement between PH and ED GCS scores, with no significant median difference, although mild and severe TBI subgroups, alcohol or drug intoxication, intracranial pressure (ICP) monitor use, and mortality showed statistically significant but clinically minor differences. Injury Severity Score (ISS) and transport time did not significantly affect GCS agreement. The findings support the reliability of GCS as a communication tool between PH and ED providers while highlighting the need for cautious interpretation in specific clinical contexts and ongoing provider education.