Journal of Pediatric Rehabilitation Medicine · Published 2025-10-16 · DOI 10.1177/18758894251385506
Purpose The Glasgow Coma Scale (GCS) is the gold standard in assessing severity for traumatic brain injury (TBI). This study aimed to compare GCS-rated severity to caregiver-perceived severity. Researchers assessed levels of agreement and explored which factors explained any differences and predicted whether a GCS score was provided. Methods Caregiver-perceived severity, demographic, and medical information was collected via electronic survey from 107 youth with TBI. GCS-rated severity was collected via medical-chart review. Results The strength of agreement fluctuated by severity (mild/concussion k = 0.60, moderate k = 0.1, severe k = 0.64). Caregiver perceptions were more severe in 62% of cases. No medical or demographic variables explained discrepancies. GCS was documented in 38% of medical records. Binomial regression modeling found that participants seen in the emergency department were most likely to receive a GCS rating. Conclusion Results suggest that caregivers may be reliable evaluators of their child's TBI severity, particularly for those classified as mild or severe injuries with GCS ratings. Allowing caregiver-perceived severity ratings could increase inclusivity in research, so participation is not limited to children who go to the emergency department. More research is needed to determine if caregiver-perceived severity tracks with long-term outcomes or if caregivers base severity ratings on factors outside of the initial injury event.
Abstract from DOAJ. Public domain (CC0 1.0).
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