Meta-analysis of Glasgow Coma Scale and Simplified Motor Score in predicting traumatic brain injury outcomes

Balwinder Singh, M. Hassan Murad, Larry J. Prokop, Patricia J. Erwin, Zhen Wang, Shannon K. Mommer, Sonia S. Mascarenhas, Ajay K. Parsaik

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Objective: To perform a systematic review and meta-analysis to compare the Simplified Motor Score (SMS) and Glasgow Coma Scale (GCS) in predicting outcomes in patients with traumatic brain injury (TBI). Data sources and study selection: Ovid EMBASE, Ovid Medline, Ovid PsycInfo, evidence-based medicine reviews and Scopus and related conference proceedings were searched through 28 February 2012 for studies comparing SMS and GCS in predicting the outcomes [emergency tracheal intubation (ETI), clinically significant brain injuries (CSBI), neurosurgical intervention (NSI) and mortality] in patients with TBI. A random-effects model was used for meta-analysis. Data synthesis: Five retrospective studies were eligible, enrolling a total of 102 132 subjects with TBI (63.4% males), with 14 670 (14.4%) ETI, 16 201 (15.9%) CSBI, 4730 (4.6%) NSI and 6725 (6.6%) mortality. Pooled AUC of the GCS and SMS were as follows: CSBI 0.79 and 0.75 (p=0.16), NSI 0.83 and 0.81 (p=0.34), ETI 0.85 and 0.82 (p=0.31) and mortality 0.90 and 0.87 (p=0.01). The difference in AUC for mortality was 0.03. Large heterogeneity between the studies was observed in all analyses (I2>50%). Conclusion: In patients with TBI, SMS predicts different outcomes with similar accuracy as GCS except mortality. However, due to heterogeneity and limited numbers of studies, further prospective studies are required.

Original languageEnglish (US)
Pages (from-to)293-300
Number of pages8
JournalBrain Injury
Issue number3
StatePublished - 2013


  • Clinically significant brain injuries
  • Emergency tracheal intubation
  • Mortality
  • Neurosurgical intervention

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology


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