Commentary on: Jennett, B.,Bond, M., Assessment of outcome after severe brain damage.. Lancet 1(7905): 480 - 484, 1975Rami O Almefty, MD1, Zaman Mirzadeh, MD2, Peter Nakaji, MD21Department of Neurosurgery, Barrow Neurological Institute 2Barrow Neurological Institute Keywords: traumatic brain injury, quality of life, head injury, outcome, grading systemInteractive ManuscriptAsk Questions of this Manuscript: What questions did this manuscript seek to answer?This paper''''s goal was to develop a clear, objective scale to assess outcome after head injury that was not overly optimistic and allowed accurate evaluation of early management. The scale sought to correct previously vague and overly optimistic scales and to evaluate effectiveness of early management strategies. Describe the design of this manuscript.expert opinion List the inclusion and exclusion criteria for the study population.This scale was initially described for patients suffering from traumatic brain injury but is now used in other clinical contexts. What were the results of this manuscript?This paper describes the Glasgow outcome scale which is as follows: 1-death 2-persistent vegetative state 3-severe disability (dependent for daily support) 4-moderate disability (independent for daily life) 5-good recovery (normal life, may have deficits) Highlight any other important points that this manuscript covered.The scale is complicated by prolonged time scale over which recovery may
occur. For example, many thought to never work again at 3 years are working at
11 years. The paper also provides some insight on the timing and degree of recovery after traumatic brain injury. Notable examples include: (1) over 1/3 of patients severely disabled at 3 months improved to moderate disability
by 1 year, but none showed good recovery, (2) over 1/3 of patients moderately disabled
at 3 months were good by 1 year, and (3) all patients with over 3 weeks post-traumatic amnesia had persisting mental handicap of some degree. Are there any questions or ideas for the future that you would pose to the authors?This question was not answered by the author Please describe how you would improve this report or the research that was done.This question was not answered by the author This paper''''s goal was to develop a clear, objective scale to assess outcome after head injury that was not overly optimistic and allowed accurate evaluation of early management. The scale sought to correct previously vague and overly optimistic scales and to evaluate effectiveness of early management strategies. expert opinion
This scale was initially described for patients suffering from traumatic brain injury but is now used in other clinical contexts. This paper describes the Glasgow outcome scale which is as follows: 1-death 2-persistent vegetative state 3-severe disability (dependent for daily support) 4-moderate disability (independent for daily life) 5-good recovery (normal life, may have deficits)
The scale is complicated by prolonged time scale over which recovery may
occur. For example, many thought to never work again at 3 years are working at
11 years. The paper also provides some insight on the timing and degree of recovery after traumatic brain injury. Notable examples include: (1) over 1/3 of patients severely disabled at 3 months improved to moderate disability
by 1 year, but none showed good recovery, (2) over 1/3 of patients moderately disabled
at 3 months were good by 1 year, and (3) all patients with over 3 weeks post-traumatic amnesia had persisting mental handicap of some degree. Project Roles:
R. Almefty (Manuscript Writing), Z. Mirzadeh (Critically Revising the Manuscript), P. Nakaji (Final Approval of the Manuscript)
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