Limits of the Glasgow Coma Scale When Assessing for Sepsis in Allogeneic Hematopoietic Cell Transplant Recipients.

The study was done at one transplant center, so Glasgow Coma Scale recording may reflect that center's practices. Only 100 suspected infections were reviewed, so the estimates are imprecise. Glasgow Coma Scale assessment was not required and was not open by default in the electronic medical record, so missing scores may be due to documentation habits rather than clinical status. Altered mental status was judged from existing clinical records, not from a standardised assessment performed for the study. AVPU scores were captured less than 5% of the time, so AVPU could not be evaluated as an alternative indicator. Patients with recorded Glasgow Coma Scale scores were younger and more likely to have unrelated donor stem cells than patients without recorded scores.

The supplied text does not include a conflicts-of-interest statement; the article is tagged as supported by NIH extramural and non-U.S. government research support.

Do not conclude that a Glasgow Coma Scale score of 15 rules out altered mental status or that missing scores mean no mental status change. In this review, a score below 15 identified only 60.0% of documented altered mental status events, and 18 of 28 documented events had no Glasgow Coma Scale score.